MEDICARE: DR. HOWARD TUNG M.D.

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
1	207T00000X	Neurological Surgery Physician	G058235	CA

General Provider Information

NPI Number	:	1538153341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOWARD TUNG M.D.

Provider Business Mailing Address
First Line	:	4510 EXECUTIVE DR
Second Line	:	SUITE 125
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-3021
Country	:	US
Telephone Number	:	858-643-5650
Fax Number	:	858-643-5660

Provider Business Practice Location Address
First Line	:	4510 EXECUTIVE DR
Second Line	:	SUITE 125
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-3021
Country	:	US
Telephone Number	:	858-643-5650
Fax Number	:	858-643-5660

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	08/26/2011

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