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NPI Code Detail

MEDICARE: HENRY I. KUNG, M.D., A PROFESSIONAL CORPORATION

MEDICARE: HENRY I. KUNG, M.D., A PROFESSIONAL CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistG39076CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11518941673OTHERCANPI

General Provider Information

NPI Number : 1083933154
Entity Type Code : Organization
Provider Name (Legal Business Name) : HENRY I. KUNG, M.D., A PROFESSIONAL CORPORATION
Provider Business Mailing Address
First Line : 120 LA CASA VIA
Second Line : STE 107
City : WALNUT CREEK
State : CA
Zip : 94598-3067
Country : US
Telephone Number : 925-945-6070
Fax Number : 925-945-8767
Provider Business Practice Location Address
First Line : 120 LA CASA VIA
Second Line : STE 107
City : WALNUT CREEK
State : CA
Zip : 94598-3067
Country : US
Telephone Number : 925-945-6070
Fax Number : 925-945-8767
Authorized Official
Title or Position : BILLING MANAGER
Name : JULIET KUNG
Credential :
Telephone Number : 925-945-6070
Provider Enumeration Date : 05/27/2010
Last Update Date : 05/27/2010

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Directions to “HENRY I. KUNG, M.D., A PROFESSIONAL CORPORATION ” Practice Location

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