Ryan Fong
Physician Assistant

Address: 15004 Innovation Drive (s97), San Diego, CA 92128
Phone: 8585547439

Ryan Fong (NPI# 1336659218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1336659218
Entity Type Individual
Full Name Ryan Fong
Credential PA-C
Gender Male
Practice Address 15004 Innovation Drive (s97)
San Diego
CA 92128
Practice Telephone 8585547439
Mailing Address 10790 Rancho Bernardo Rd
Mail Drop 4s-205
San Diego
CA 92127
Mailing Telephone 8586057171
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2017-10-05
Last Update Date 2019-12-26

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers

Providers with the same name

NPI Name Taxonomy Address Enumeration
1154621860 Ryan J Fong Physician Assistant 54 Miller St Ste 201, Quincy, MA 02169-4725 2010-10-27
1336458611 Ryan Fong Acupuncturist 1060 E Green St Ste 106, Pasadena, CA 91106-2413 2010-10-04

Physician Overview

NPI 1336659218
PAC ID by PECOS 4880954791
Professional Enrollment ID I20180213002583
Full Name Ryan C Fong
Organization Legal Name LODI MEMORIAL HOSPITAL ASSOCIATION INC
Phone Number 2093343411
Gender M
Graduation Year 2017
Primary Specialty PHYSICIAN ASSISTANT
Group Practice PAC ID 7618880717
Number of Group Practice Members 62
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
050336 ADVENTIST HEALTH LODI MEMORIAL

Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1053907279 Vanna Vo Physician Assistant 1233 Sandy Cape Ct, San Diego, CA 92154-5800 2020-12-13
1588260780 Erik Duque Physician Assistant 8194 Torrey Gardens Pl, San Diego, CA 92129-4601 2020-12-11
1821693490 Ivan James Turpin Physician Assistant 4774 Chickasaw Ct, San Diego, CA 92117-2840 2020-12-02
1083213706 Courtney Kathryn Hopp Physician Assistant 4060 Fourth Ave Ste 209, San Diego, CA 92103-2120 2020-10-23
1639776503 Nathan Tuan Dinh Physician Assistant 8296 Via Escalada, San Diego, CA 92129-2223 2020-10-05
1750988671 Denise Aquino Physician Assistant 7322 Mesa College Dr Apt 7, San Diego, CA 92111-4943 2020-10-04
1962009183 Courtney Krysl Physician Assistant 14434 Corte Lampara, San Diego, CA 92129-3818 2020-10-01
1497369284 Brian Carroll Physician Assistant 7242 Melotte St, San Diego, CA 92119-1613 2020-08-31
1871104067 Satoshi Ikeda Physician Assistant 16198 Paseo Del Sur, San Diego, CA 92127-6155 2020-08-12
1760009989 Lili Tran Physician Assistant 8865 Calle Tragar, San Diego, CA 92129-2156 2020-07-03
Find all providers in SAN DIEGO

Office Location

Street Address 15004 INNOVATION DRIVE (S97)
City SAN DIEGO
State CA
Zip Code 92128

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1518585371 Alicia Ford Behavior Technician 1170 Bernardo Plaza Court, Suite 350, San Diego, CA 92128 2020-07-08
1164087573 Madeleine White Dietitian, Registered 16685 W Bernardo Dr, Suite 121, San Diego, CA 92128 2019-05-01
1053807677 Joele Ghosn Speech-Language Pathologist 11838 Bernardo Plaza Ct #110, San Diego, CA 92128 2018-07-06
1376034348 Eddie Reginald Burston II In Home Supportive Care 12727 Camino Emparrado, San Diego, CA 92128 2018-05-24
1508316191 Araceli Flores Behavior Analyst 15737 Innovation Dr, Suite 200, San Diego, CA 92128 2016-10-07
1003283961 Katherine Dishner Hearing Instrument Specialist 16766 Bernardo Center Dr Ste 206, San Diego, CA 92128 2015-08-27
1205212586 Mobilia Dmd Inc. Point of Service 12405 Rancho Bernardo Rd., San Diego, CA 92128 2015-08-10
1346623634 Angela Christine Storck-petersen Dietitian, Registered 11768 Caminito Corriente, San Diego, CA 92128 2015-07-04
1134526874 Breeana Rose Lancaster Speech-Language Pathologist 11838 Bernardo Plaza Ct. Suite 110, Kids Therapy Associates, San Diego, CA 92128 2014-11-24
1730595570 Charity Fluegge Developmental Therapist 11770 Bernardo Plaza Ct Ste 350, San Diego, CA 92128 2014-07-01
Find all providers in zip 92128

Competitor

Search similar providers

City SAN DIEGO
Zip Code 92128

Improve Information

Please comment or provide details below to improve the information on Ryan Fong.

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.