BRYAN PHILIP FONG (NPI# 1033297163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033297163 |
| Entity Type | Individual |
| Full Name | BRYAN PHILIP FONG |
| Credential | MD |
| Practice Address |
1425 S Main St Walnut Creek CA 94596-5318 |
| Mailing Address |
1800 Harrison St Fl 7 Oakland CA 94612-3429 |
| Practice Telephone | 9252954000 |
| Mailing Telephone | 5106256262 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | G81504 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G815040 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588905202 | Bryan Fong | Massage Therapist | 5258 S Pinemont Dr # B-105, Murray, UT 84123-4614 | 2013-03-05 |
| 1811139637 | Bryan Jun Fong | Anesthesiology | 24451 Health Center Dr, Laguna Hills, CA 92653-3689 | 2009-03-25 |
| 1548348634 | Bryan Fong | Internal Medicine | 200 Muir Rd, Martinez, CA 94553-4614 | 2006-11-02 |
| Street Address |
1425 S MAIN ST |
| City | WALNUT CREEK |
| State | CA |
| Zip Code | 94596-5318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356342638 | Ingrid Wendy Fernandes | Internal Medicine | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2005-08-09 |
| 1982221297 | Michelle Nhumai Huynh | Pharmacist | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2020-07-02 |
| 1144869322 | Darrell James David | Registered Nurse | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2020-01-05 |
| 1306484530 | Kayla Galanter | Pharmacist | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2019-12-18 |
| 1184260804 | Carol Jean Mcmenamy | Social Worker | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2019-11-18 |
| 1871138990 | Gloria Yatmen Lai | Registered Nurse | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2019-11-12 |
| 1851945901 | Zsanell Go | Physical Therapist | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2019-07-26 |
| 1043776453 | Bridget Rochios | Registered Nurse | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2019-02-11 |
| 1518423920 | Britnie Lee Milam | Respiratory Therapist, Registered | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2019-02-11 |
| 1326503244 | Megan R Moore | Respiratory Therapist, Registered | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2019-02-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467917229 | Alison M Khaddour | Behavior Technician | 800 S Broadway Ste. 310, Walnut Creek, CA 94596 | 2019-02-06 |
| 1134683618 | Ian Colas | Respiratory Therapist, Certified | 1425 South Main Street, Walnut Creek, Walnut Creek, CA 94596 | 2019-01-29 |
| 1912474131 | Albert Dizon Miraflores | Behavior Technician | 1910 Olympic Blvd Walnut Creek Ca 94596, Walnut Creek, CA 94596 | 2018-10-25 |
| 1487136834 | Daryn Stier | Social Worker | 80 Norlyn Drive, Walnut Creek, CA 94596 | 2018-09-02 |
| 1831682335 | Jessica Lim | Registered Nurse | 1357 Oakland Blvd, Walnut Creek, CA 94596 | 2018-06-08 |
| 1699278432 | Alanna Everhart | Behavior Technician | 877 Ygnacio Valley Road, Suite 100, Walnut Creek, CA 94596 | 2018-03-16 |
| 1962958108 | Derek Jue Md | Clinic/Center | 1812 San Miguel Drive, Walnut Creek, CA 94596 | 2016-08-28 |
| 1912369711 | Pamela Jean Lister | Marriage & Family Therapist | 2070 N Broadway, #5370, Walnut Creek, CA 94596 | 2016-03-22 |
| 1548635147 | Anne Lamoreaux Anderson | Behavioral Analyst | 800 South Broadway Suite #310, Walnut Creek, CA 94596 | 2015-12-08 |
| 1346619434 | Christine Anne Gotelli | Registered Nurse | 370 N. Civic Drive #311, San Francico, CA 94596 | 2015-09-18 |
| Find all providers in zip 94596 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366701385 | Joshua Au | Otolaryngology | 365 Lennon Ln Ste 280, Walnut Creek, CA 94598-5915 | 2012-05-11 |
| 1164438875 | Erica Christine Bennett | Otolaryngology | 106 La Casa Via Ste 100, Walnut Creek, CA 94598-3084 | 2006-08-01 |
| 1275799124 | Haena Kim | Otolaryngology | 106 La Casa Via, Suite 200, Walnut Creek, CA 94598-3086 | 2008-07-31 |
| 1952596744 | Christopher Apostol Mascarinas | Otolaryngology | 1425 S Main St, Department of Head and Neck Surgery, Walnut Creek, CA 94596-5318 | 2007-09-13 |
| 1629293030 | Betty Sheau-jing Tsai Do | Otolaryngology | 1515 Newell Ave, Walnut Creek, CA 94596-5120 | 2007-04-13 |
| 1710056924 | Gregory Yu Chin | Otolaryngology | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2006-11-06 |
| 1033297114 | Glenn D. Schneider | Otolaryngology | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2006-11-02 |
| 1629156781 | Elizabeth Huang | Otolaryngology | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2006-11-02 |
| 1487732574 | Basil Adad | Otolaryngology | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2006-11-02 |
| 1285712380 | Cornelius J.a. Jansen | Otolaryngology | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2006-11-02 |
| Find all providers in WALNUT CREEK | ||||
| City | WALNUT CREEK |
| Zip Code | 94596 |
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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.