Healthcare Provider Details

I. General information

NPI: 1427017185
Provider Name (Legal Business Name): SHIANG-CHENG KUNG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 VAN NESS AVE
SAN FRANCISCO CA
94109-6978
US

IV. Provider business mailing address

41 MALL RD LAHEY HOSPITAL AND MEDICAL CENTER
BURLINGTON MA
01805-0001
US

V. Phone/Fax

Practice location:
  • Phone: 415-600-1070
  • Fax:
Mailing address:
  • Phone: 781-744-2500
  • Fax: 781-744-5397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberC143042
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: