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Dr. Peolia Kansas Fonsworth III, MD,MBA
Addiction Medicine (Psychiatry & Neurology) Physician in Torrance, California
NPI 1639412091

Peolia Kansas Fonsworth III is an Addiction Medicine (Psychiatry & Neurology) Physician based in Torrance, CA and is specialized in Addiction Medicine. Peolia Kansas Fonsworth III practices in Torrance, CA and has the professional credentials of MD,MBA. The NPI Number for Peolia Kansas Fonsworth III is 1639412091 and holds a License No. A132680 (California).

The current practice location address for Peolia Kansas Fonsworth III is 1000 W Carson St, Torrance, CA and can be reached out via phone at 310-222-2345.

Location: 1000 W Carson St, Torrance, CA, 90502-2004
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1639412091
Provider Name
Peolia Kansas Fonsworth III
Credential
MD,MBA
Provider Entity Type
Individual
Gender
Male
Address
1000 W Carson St, Torrance, CA, 90502-2004
Phone Number
310-222-2345
Fax Number
Provider Enumeration Date
04/03/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1000 W Carson St
City
Torrance
State
California
Zip
90502-2004
Phone Number
310-222-2345
Fax Number
person
Provider Business Mailing Address Details
Address
1000 W Carson St
City
Torrance
State
California
Zip
90502-2004
Phone Number
310-222-2345
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
A132680 (California)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Psychiatry & Neurology
Speciality
Addiction Medicine
Taxonomy
2084A0401X
License No.
()
Definition
A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine
person
Provider's Taxonomy Details 3
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
A132680 (California)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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