Healthcare Provider Details

I. General information

NPI: 1881810927
Provider Name (Legal Business Name): ELLEN B FUNG PHD, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELLEN J BIEHL

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 MARTIN LUTHER KING JR WAY HEDCO HEALTH SCIENCE CENTER
OAKLAND CA
94609-1673
US

IV. Provider business mailing address

6618 DOVER ST
OAKLAND CA
94609-1012
US

V. Phone/Fax

Practice location:
  • Phone: 510-428-3885
  • Fax: 510-450-5877
Mailing address:
  • Phone: 510-428-3885
  • Fax: 510-450-5877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number836890
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2471B0102X
TaxonomyBone Densitometry Radiologic Technologist
License NumberRHP81470
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: