MEDICARE: KWOK CHEUNG HUNG 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	207Q00000X	Family Medicine Physician	G28237	CA
2	207QG0300X	Geriatric Medicine (Family Medicine) Physician	G28237	CA

General Provider Information

NPI Number	:	1700924388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KWOK CHEUNG HUNG M.D.

Provider Business Mailing Address
First Line	:	10338 MIRA VISTA RD
Second Line	:
City	:	CUPERTINO
State	:	CA
Zip	:	95014-2745
Country	:	US
Telephone Number	:	408-931-6472
Fax Number	:

Provider Business Practice Location Address
First Line	:	10338 MIRA VISTA RD
Second Line	:
City	:	CUPERTINO
State	:	CA
Zip	:	95014-2745
Country	:	US
Telephone Number	:	408-931-6472
Fax Number	:

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

Provider Enumeration Date	:	02/03/2007
Last Update Date	:	08/08/2012

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