Healthcare Provider Details

I. General information

NPI: 1689680100
Provider Name (Legal Business Name): PEGGY TUN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 08/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 HOSPITAL DR STE 311
MOUNTAIN VIEW CA
94040-4126
US

IV. Provider business mailing address

2490 HOSPITAL DR STE 311
MOUNTAIN VIEW CA
94040-4126
US

V. Phone/Fax

Practice location:
  • Phone: 650-962-4690
  • Fax: 650-962-4694
Mailing address:
  • Phone: 650-962-4690
  • Fax: 650-962-4694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080I0007X
TaxonomyPediatric Clinical & Laboratory Immunology Physician
License NumberG27696
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: