Healthcare Provider Details

I. General information

NPI: 1255787461
Provider Name (Legal Business Name): TRACY TSUI-YING HUNG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2016
Last Update Date: 08/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15715 S 46TH ST SUITE 102
PHOENIX AZ
85048
US

IV. Provider business mailing address

9059 W LAKE PLEASANT PARKWAY SUITE E540
PEORIA AZ
85382
US

V. Phone/Fax

Practice location:
  • Phone: 480-496-6444
  • Fax:
Mailing address:
  • Phone: 623-234-3283
  • Fax: 623-234-3723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number57791
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: