MATTHEW BRYAN FONG


Address: 250 S G St, San Bernardino, CA 92410-3320
Phone: 9093827100

MATTHEW BRYAN FONG (NPI# 1346412244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1346412244
Entity Type Individual
Full Name MATTHEW BRYAN FONG
Credential M.D.
Practice Address 250 S G St
San Bernardino
CA 92410-3320
Mailing Address Coleman Pavilion, Room A1121
11175 Campus Street
Loma Linda
CA 92350
Practice Telephone 9093827100
Mailing Telephone (909) 558-8142
Enumeration Date 2008-03-31
Last Update Date 2018-03-17
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208000000X Pediatrics A113013 CA Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
11175 Campus St, Loma Linda, CA 923501700 9095584174

Office Location

Street Address 250 S G ST
City SAN BERNARDINO
State CA
Zip Code 92410-3320

Providers in the same location

NPI Name Taxonomy Address Enumeration
1528693504 Sac Health System Clinic/Center 250 S G St, San Bernardino, CA 92410-3320 2020-03-10
1437784410 Sac Health System Clinic/Center 250 S G St, San Bernardino, CA 92410-3320 2020-03-10
1275167926 Alma Rosa Vazquez Social Worker 250 S G St, San Bernardino, CA 92410-3320 2020-03-02
1407494750 Joshua Joseph Masih Nurse Practitioner 250 S G St, San Bernardino, CA 92410-3320 2019-12-17
1366085359 Anna Kim Pharmacist 250 S G St, San Bernardino, CA 92410-3320 2019-10-22
1104467190 Karin Cecilia Ulltjaern Nurse Practitioner 250 S G St, San Bernardino, CA 92410-3320 2019-10-01
1144781733 Monique Roach Social Worker 250 S G St, San Bernardino, CA 92410-3320 2019-03-27
1043721939 Sac Health System Family Medicine 250 S G St, San Bernardino, CA 92410-3320 2017-10-18
1538688486 Rocco J Massimiano Pharmacist 250 S G St, San Bernardino, CA 92410-3320 2017-09-12
1497275747 Cecilia Kristell Martinez Dietitian, Registered 250 S G St, San Bernardino, CA 92410-3320 2017-06-27
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1902303472 Reina Elora Garcia Student in an Organized Health Care Education/Training Program 775 E Base Line St Spc 4, San Bernardino, CA 92410 2018-04-10
1558889881 Salaunge Lopez Non-emergency Medical Transport (VAN) 25942 Baseline St Apt D203, San Bernardino, CA 92410 2017-09-07
1902328578 Kelly Canady Counselor 1100 N. D St., San Bernardino, CA 92410 2017-07-14
1881058592 Terron Thomas Contractor 445 South G, Unit B, San Bernardino, IN 92410 2016-04-08
1982064572 Zachary Norton-martinez Specialist/Technologist 650 Del Rosa Dr, San Bernardino, CA 92410 2016-02-25
1003280934 Brenda Boyle Nurse Practitioner 1455 East 3rd Street, San Bernardino, CA 92410 2015-11-16
1689045197 Bryan Carter Physician Assistant 1455 E 3rd Street, San Bernardino, CA 92410 2015-10-09
1801270137 Sac Health System Clinic/Center 250 South G Street, San Bernardino, CA 92410 2015-07-16
1467852269 Wilson Dentistry, Inc. Dentist 1063 N. D St, San Bernardino, CA 92410 2014-08-28
1629405345 Terrence John Forrester Social Worker 1455 E. 3rd St, San Bernardino, CA 92410 2013-09-27
Find all providers in zip 92410

Taxonomy Information

Taxonomy Code 208000000X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics

Taxonomy Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio
- Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1982987095 Apex Pediatrics Inc Pediatrics 399 E Highland Ave Ste 329, San Bernardino, CA 92404-3861 2011-09-25
1639400708 Roshunda Michelle Coleman Pediatrics 190 E. Highland Blvd., San Bernardino, CA 92405-3658 2010-01-28
1124255146 Angie Bagheri Cook Pediatrics 565 N. Mount Vernon Ave, San Bernardino, CA 92411 2009-06-17
1700058526 Rishikesh S Chavan Pediatrics 250 E Caroline St Ste E, San Bernardino, CA 92408-3758 2008-04-01
1629249859 Tara Rithaporn Agena Pediatrics 565 North Mt Vernon Ave, San Bernardino, CA 92411-2661 2008-03-15
1073795027 Irene Styadi Tsai Pediatrics 685 Carnegie Dr, Ste. #230, San Bernardino, CA 92408-3502 2007-12-01
1235351206 Edgar Eduardo Alfaro- Mcfield Pediatrics 1800 Western Ave Ste 305, San Bernardino, CA 92411-1354 2007-05-02
1659497535 Alan Irving Lee Pediatrics 1906 Commercenter E Ste 101, San Bernardino, CA 92408-3423 2007-03-22
1679612212 Aena D Han Pediatrics 1505 W 17th St Ste 1, San Bernardino, CA 92411-1202 2007-02-06
1598836561 Tien Ngoc Dinh Pediatrics 625 Carnegie Dr Ste 280, San Bernardino, CA 92408-3577 2006-11-13
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Competitor

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City SAN BERNARDINO
Zip Code 92410

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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