Healthcare Provider Details

I. General information

NPI: 1962468215
Provider Name (Legal Business Name): LYNN HUNG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 12/07/2021
Certification Date: 12/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1017 S FAIR OAKS AVE
PASADENA CA
91105-2621
US

IV. Provider business mailing address

FILE 50475
LOS ANGELES CA
90074-0475
US

V. Phone/Fax

Practice location:
  • Phone: 626-403-6200
  • Fax:
Mailing address:
  • Phone: 626-403-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberG82327
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: