Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. PEOLIA KANSAS FONSWORTH III, M.D., M.B.A
Active Sole ProprietorDR. PEOLIA KANSAS FONSWORTH III, M.D., M.B.A is a Addiction Psychiatry healthcare provider located in TORRANCE, California. NPI 1639412091 is currently active in the NPPES registry. Verify at CMS.
Addiction Psychiatry · TORRANCE, CA
Registration Details
- NPI Number
- 1639412091
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 3, 2013 (13.353158276356 yrs)
- Last Updated
- Jun 21, 2023
- Licenses
-
A132680 (CA)A132680 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1000 W CARSON STTORRANCE, CA, 905022004Browse CA providers · Browse ZIP 90502
- Phone
- 3102222345
- Primary Specialty
-
Addiction Psychiatry
2084A0401X
- Additional Specialty
- Student (Health Education/Training)
- Additional Specialty
- Addiction Psychiatry
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.