Healthcare Provider Details

I. General information

NPI: 1649874504
Provider Name (Legal Business Name): JOSEPH FUNG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2020
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 S GARFIELD AVE FL 2
ALHAMBRA CA
91801-5859
US

IV. Provider business mailing address

707 S GARFIELD AVE FL 2
ALHAMBRA CA
91801-5859
US

V. Phone/Fax

Practice location:
  • Phone: 626-282-1600
  • Fax: 626-656-1261
Mailing address:
  • Phone: 626-282-1600
  • Fax: 626-656-1261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberPA59920
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: