Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Peolia Kansas Fonsworth III, MD, MBA

Individual provider Specialist · NPI 1639412091

Dr. Peolia Kansas Fonsworth III, MD, MBA is a Psychiatry in Torrance, California. Graduated from University of California, Irvine, California College of Medicine in 2013, 13 years ago. Practices with Martin Luther King Jr Community Medical Foundation, a 191-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
13
Trained at
University of California, Irvine, California College of Medicine
Licensed in
CA
In the registry since
2013
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.
MBA — Master of Business Administration
A graduate business degree.

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Practice location Address checks out

1000 W Carson St
Torrance, CA 90502-2004
Phone: (310) 222-2345
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction Medicine (Psychiatry & Neurology) Physician (primary) Taxonomy 2084A0401X · Licence A132680 (CA)
Specialist Taxonomy 174400000X · Licence A132680 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1639412091
Entity typeIndividual (Type 1)
GenderMale
Credentials MD , MBA
Sole proprietorYes
NPI enumeratedApril 3, 2013
Last updated in NPPESJune 21, 2023
Certification dateJune 21, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolUNIVERSITY OF CALIFORNIA, IRVINE, CALIFORNIA COLLEGE OF MEDICINE
Graduated 2013 (13 years in practice)
Group practice Martin Luther King Jr Community Medical Foundation — 191 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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