Healthcare Provider Details
I. General information
NPI: 1740213107
Provider Name (Legal Business Name): HUICHUNG TINA LING M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/09/2006
Last Update Date: 01/18/2022
Certification Date: 01/18/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
39400 PASEO PADRE PKWY
FREMONT CA
94538-2310
US
IV. Provider business mailing address
39400 PASEO PADRE PKWY
FREMONT CA
94538-2310
US
V. Phone/Fax
- Phone: 510-248-3000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | A124567 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: