Provider Demographics
NPI:1912532342
Name:FONG, KURENE MEI-HO (PA-C)
Entity Type:Individual
Prefix:
First Name:KURENE
Middle Name:MEI-HO
Last Name:FONG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 E SPRUCE AVE STE 431
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3330
Mailing Address - Country:US
Mailing Address - Phone:559-450-7449
Mailing Address - Fax:559-450-7470
Practice Address - Street 1:1105 E SPRUCE AVE STE 201
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3313
Practice Address - Country:US
Practice Address - Phone:559-450-2630
Practice Address - Fax:559-450-0351
Is Sole Proprietor?:No
Enumeration Date:2020-03-05
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant