LEO L. FONG (NPI# 1215047659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215047659 |
| Entity Type | Individual |
| Full Name | LEO L. FONG |
| Credential | MD |
| Practice Address |
1247 E Alluvial Ave Ste 101 Fresno CA 93720-2686 |
| Mailing Address |
2625 E Divisadero St Fresno CA 93721-1431 |
| Practice Telephone | 5594316226 |
| Practice Fax Number | 5594409005 |
| Mailing Telephone | 5594432682 |
| Mailing Fax Number | 5594432681 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2019-11-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | G79576 | CA | Allopathic & Osteopathic Physicians |
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
G79576 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RAILROAD MEDICARE | P00238615 | 01 |
| CA | 00G795760 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5448 Avenida De Los Robles, Visalia, CA 932915174 | 5597214910 | 5597214920 |
| 6215 N Fresno St Ste 103, Fresno, CA 937105267 | 5594316226 | 5594409005 |
| 1850 Floral Ave, Selma, CA 936622871 | 5597214910 | 5597214920 |
| Street Address |
1247 E ALLUVIAL AVE STE 101 |
| City | FRESNO |
| State | CA |
| Zip Code | 93720-2686 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902877236 | Anne Marie Prentice | Specialist | 1247 E Alluvial Ave Ste 101, Fresno, CA 93720-2686 | 2006-01-26 |
| 1881099141 | Robert R Baber | Physician Assistant | 1247 E Alluvial Ave Ste 101, Fresno, CA 93720-2686 | 2014-10-29 |
| 1538402581 | Sammy Siada | Surgery | 1247 E Alluvial Ave Ste 101, Fresno, CA 93720-2686 | 2013-03-28 |
| 1194023259 | Leigh Ann O'banion | Surgery | 1247 E Alluvial Ave Ste 101, Fresno, CA 93720-2686 | 2011-03-14 |
| 1558522094 | Kamell Rashad Eckroth-bernard | Surgery | 1247 E Alluvial Ave Ste 101, Fresno, CA 93720-2686 | 2008-06-18 |
| 1376738773 | Maria Winona Mcknight | Registered Nurse | 1247 E Alluvial Ave Ste 101, Fresno, CA 93720-2686 | 2007-09-09 |
| 1962512319 | Randall Gordon Stern | Surgery | 1247 E Alluvial Ave Ste 101, Fresno, CA 93720-2686 | 2006-08-30 |
| 1699712349 | Philip A. Hinton | Surgery | 1247 E Alluvial Ave Ste 101, Fresno, CA 93720-2686 | 2006-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366061129 | Ariel Lok Yen Leung | Student in an Organized Health Care Education/Training Program | 1313 East Herndon Ave, St 105, Fresno, CA 93720 | 2020-04-13 |
| 1457992513 | Brittany Nichole Willis | Audiologist | 1351 E Spruce Ave Ste 130, Fresno, CA 93720 | 2019-09-30 |
| 1013567668 | Taylor Courteney Cox | Physical Therapist | 7080 N. Maple Ave #101, Fresno, CA 93720 | 2019-09-16 |
| 1457909152 | Lillian M Augilera | Technician | 8419 N Dearing Ave, Fresno, CA 93720 | 2019-08-27 |
| 1215581764 | Sterling Hospitalist Medical Group, Inc. | Clinic/Center | 1191 E. Herndon Avenue Suite 103, Fresno, CA 93720 | 2019-08-01 |
| 1376006429 | Nancy Minh Thao Dang | Student in an Organized Health Care Education/Training Program | 1313 E. Herndon Ave, St 105, Fresno, CA 93720 | 2019-04-06 |
| 1366904716 | Shankar Nair | Student in an Organized Health Care Education/Training Program | 1313 E. Herndon Ave, St 105., Fresno, CA 93720 | 2019-04-04 |
| 1861979544 | Powell Pediatric Dentistry Chestnut Partnership | Dentist | 7005 N. Chestnut Ave Ste 101, Fresno, CA 93720 | 2018-07-25 |
| 1669967311 | Sierra Pacific Orthopaedic Center Medical Group Inc | Specialist | 1270 E. Spruce, Fresno, CA 93720 | 2018-06-26 |
| 1689168700 | Vinita Vishnoi | Student in an Organized Health Care Education/Training Program | 1313 E. Herndon Ave, St 105, Fresno, CA 93720 | 2018-06-21 |
| Find all providers in zip 93720 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265714620 | Vascular and Cardiothoracic Surgical Group, Inc | Surgery | 4650 N Palm Ave, Fresno, CA 93704-3035 | 2011-09-12 |
| 1073775748 | Soohyun Kim | Surgery | 1191 E Herndon Ave Ste 102, Fresno, CA 93720-3164 | 2008-06-25 |
| 1912033853 | Fitzalbert Michael Marius Sr. | Surgery | 3222 W Kearney Blvd, Fresno, CA 93706-2215 | 2007-02-26 |
| 1467454686 | Eric Ladenheim | Surgery | 6145 N Thesta St, Fresno, CA 93710-5266 | 2005-06-01 |
| 1114005246 | John Geren Nichols | Surgery | 7300 N Fresno St, Fresno, CA 93720-2941 | 2006-11-02 |
| 1881772614 | Abed Y. Joseph | Surgery | 7300 N Fresno St, Fresno, CA 93720-2941 | 2006-11-01 |
| 1073619870 | Andras Bikk | Surgery | 2615 E Clinton Ave, Va-central California Dept of Surgery -112, Fresno, CA 93703-2223 | 2006-09-16 |
| 1881799161 | William E Hadcock, Jr, Md, Inc. | Surgery | 1247 E Alluvial Ave, Ste. 101, Fresno, CA 93720-2686 | 2006-09-13 |
| 1154353795 | William E Hadcock | Surgery | 1247 E Alluvial Ave, Ste. 101, Fresno, CA 93720-2686 | 2006-07-06 |
| 1083655534 | James Ho Lee | Surgery | 1191 E Herndon Ave, #102, Fresno, CA 93720-3164 | 2006-06-08 |
| Find all providers in FRESNO | ||||
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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.