| Provider / Organization | NPI | Date Certified |
|---|---|---|
| PRESTON FONG | 1871223271 | 2023-05-07 |
Preston Fong is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1871223271. Registration indicates Preston Fong is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
| Entity Type | Individual |
| Provider Name | Preston Fong |
| Practice Office Address | 1500 S MAIN ST FORT WORTH, TX US |
| Practice Office Telephone | 8177026936 |
| Mailing Address | 7633 EAST JEFFERSON, SUITE 70 DETROIT, MI 48214 US |
| Business Telephone | 3134994775 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 7633 East Jefferson, Suite 70 | Detroit, MI 482144917 | 3134994775 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X PRIMARY | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care |