Healthcare Provider Details
I. General information
NPI: 1134860166
Provider Name (Legal Business Name): SHUNA JUNG DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/05/2022
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
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: 510-767-5421
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 22014 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: