Richard T Fong, MD | |
99 Montecillo Rd, San Rafael, CA 94903-3308 | |
(415) 444-2000 | |
Not Available |
Full Name | Richard T Fong |
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Gender | Male |
Speciality | Orthopaedic Surgery |
Location | 99 Montecillo Rd, San Rafael, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033293105 | NPI | - | NPPES |
00G474290 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
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207X00000X | Orthopaedic Surgery | G47429 (California) | Primary |
Entity Name | University Of California Sfgh Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760457816 PECOS PAC ID: 5496668410 Enrollment ID: O20031229000429 |
Mailing Address | Practice Location Address |
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Richard T Fong, MD 1800 Harrison St Fl 7, Oakland, CA 94612-3429 Ph: (510) 625-6262 | Richard T Fong, MD 99 Montecillo Rd, San Rafael, CA 94903-3308 Ph: (415) 444-2000 |
Alex V. Prescott, MD Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 99 Montecillo Rd, San Rafael, CA 94903 Phone: 415-444-2000 | |
Dr. Peter Douglas Mcqueen, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 99 Montecillo Rd, San Rafael, CA 94903 Phone: 415-444-4430 | |
John F. Safanda, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 99 Montecillo Rd, San Rafael, CA 94903 Phone: 415-444-2000 | |
Francois S. Antounian, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 99 Montecillo Rd, San Rafael, CA 94903 Phone: 415-444-2000 |