DR. ALLEN GARY FONG (NPI# 1477834463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477834463 |
| Entity Type | Individual |
| Full Name | DR. ALLEN GARY FONG |
| Credential | M.D. |
| Practice Address |
2039 Forest Ave Ste # 201 San Jose CA 95128 |
| Mailing Address |
P.o. Box 3058 Saratoga CA 95070 |
| Practice Telephone | 4088061565 |
| Practice Fax Number | 4087411595 |
| Mailing Telephone | 4088061565 |
| Mailing Fax Number | 4087411595 |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2011-09-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
C36904 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BNDD | AF7272672 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023471497 | Allen Fong | Internal Medicine | 6600 Van Aalst Blvd, Fort Benning, GA 31905-2102 | 2016-04-01 |
| Street Address |
2039 FOREST AVE STE # 201 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700869187 | Maureen Wenski | Physical Therapist | 2039 Forest Ave, #104, San Jose, CA 95128-4817 | 2005-11-21 |
| 1043825235 | Kyla Rockland-miller | Nurse Practitioner | 2039 Forest Ave, San Jose, CA 95128-4817 | 2020-09-14 |
| 1043659881 | Kim Ngoc Nguyen | Physical Therapist | 2039 Forest Ave, #104, San Jose, CA 95128-4817 | 2013-06-14 |
| 1528302155 | Lewis L Haut Md Inc | Internal Medicine | 2039 Forest Ave, #301, San Jose, CA 95128-4830 | 2012-11-20 |
| 1891041869 | Michi Yamazaki | Physical Therapist | 2039 Forest Ave, #104, San Jose, CA 95128-4817 | 2012-07-27 |
| 1053607374 | Angela Allison Tinson | Occupational Therapist | 2039 Forest Ave, 104, San Jose, CA 95128-4817 | 2011-06-24 |
| 1497040752 | Peter J. Rutti, M.d. Inc. | Eyewear Supplier (Equipment, not the service) | 2039 Forest Ave, Suite 201, San Jose, CA 95128-4817 | 2011-06-15 |
| 1669765251 | Raymond R. Rendon & Associates | Technician/Technologist | 2039 Forest Ave, Suite 206, San Jose, CA 95128-4817 | 2011-05-16 |
| 1275823775 | Lana L Fiori | Occupational Therapist | 2039 Forest Ave, #104, San Jose, CA 95128-4817 | 2011-04-18 |
| 1629379128 | Alan M. Heller M.d. Inc | Specialist | 2039 Forest Ave, 203, San Jose, CA 95128-4817 | 2010-11-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982227138 | Ruth Larsen | Social Worker | 850 S. Bascom Avenue, Suite 280, San Jose, CA 95128 | 2020-05-22 |
| 1265067185 | Of Two Minds Psychotherapy | Marriage & Family Therapist | 190 S. Bascom Ave, Ste 130, San Jose, CA 95128 | 2020-03-11 |
| 1982244166 | Cindy Pantoja Escobar | Behavior Technician | 100 O'connor Drive, Suites 21, San Jose, CA 95128 | 2020-01-15 |
| 1104460591 | Katherine Alexandra Misogas | Pharmacist | 777 Turner Dr # 330, San Jose, CA 95128 | 2019-10-29 |
| 1942842216 | Jodie Pierce | Marriage & Family Therapist | 871 Enborg Lane, San Jose, CA 95128 | 2019-10-08 |
| 1003466434 | Dong Mi Cha | Pharmacist | 777 Turner Dr Ste 330, San Jose, CA 95128 | 2019-09-17 |
| 1114571759 | Sleep Well Acupuncture, Inc | Acupuncturist | 1361 S Winchester Blvd Suite 206, San Jose, CA 95128 | 2019-08-01 |
| 1083277677 | Wellocity, Inc | Health Educator | 334 Santana Row, 318, San Jose, CA 95128 | 2019-04-18 |
| 1518428812 | Alexander Diaz | Radiology | 75 South Bascom Ave, San Jose, CA 95128 | 2019-03-28 |
| 1720542103 | Nanci R Price Inc | Chiropractor | 100 O'connor Dr., Ste 27, San Jose, CA 95128 | 2019-01-30 |
| Find all providers in zip 95128 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841563293 | Richard Eng M.d. Inc A Professional Corporation | Otolaryngology | 2360 Mckee Rd Ste 7, San Jose, CA 95116-1618 | 2012-02-15 |
| 1376725630 | Mauro B Ruffy | Otolaryngology | 2585 Samaritan Dr, San Jose, CA 95124-4107 | 2007-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073159406 | Bh Ent Group Inc | Otolaryngology | 9033 Wilshire Blvd Ste 409, Beverly Hills, CA 90211-1847 | 2019-11-20 |
| 1942719570 | Beverly Hills Head and Neck Associates | Otolaryngology | 9401 Wilshire Blvd Ste 650, Beverly Hills, CA 90212-2913 | 2017-09-27 |
| 1083135065 | Jeffrey Jumaily Md Inc | Otolaryngology | 8816 Burton Way # 1, Beverly Hills, CA 90211-1715 | 2017-06-29 |
| 1558881771 | Bel Air Surgical Institute | Otolaryngology | 11847 Wilshire Blvd Ste 302, Los Angeles, CA 90025-6634 | 2017-06-20 |
| 1912371352 | Ent Surgical Specialists Inc. | Otolaryngology | 6424 W Olympic Blvd, Los Angeles, CA 90048-5347 | 2015-11-23 |
| 1437536216 | Kiersten L. Riedler | Otolaryngology | 5405 Oberlin Dr Fl 2, San Diego, CA 92121-1700 | 2015-04-30 |
| 1114344025 | Ryan M Casserly | Otolaryngology | 966 Cass St Ste 250, Monterey, CA 93940-4541 | 2014-03-28 |
| 1558798611 | Stephen Dow Proffitt | Otolaryngology | 172 Admiral Way, Costa Mesa, CA 92627-1397 | 2013-10-03 |
| 1447693973 | Jacob Lee Wester | Otolaryngology | 200 Medical Plaza Driveway Ste 550, Ucla Department of Head and Neck Surgery, Los Angeles, CA 90095-0001 | 2013-04-15 |
| 1417294174 | Entegrative Otolaryngology PC | Otolaryngology | 1144 Sonoma Ave Ste 101, Santa Rosa, CA 95405-4812 | 2013-01-14 |
| Find all providers with the same taxonomy | ||||
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| 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.