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General NPI Number Information
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NPI Number | 1194366492
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Entity Type | Organization
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Legal Business Name | HAROLD K FUNG, DMD,INC
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Dates
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Enumeration Date | 10/08/2019
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Last Update Date | 10/08/2019
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Provider Practice Location Address
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Address Line | 345 9TH ST STE 201
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City | OAKLAND
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State | CA
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Zip | 94607-4206
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Country | US
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Telephone | 510-834-8386
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Fax | 510-834-3682
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Provider Business Mailing Address
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Address Line | 345 9TH ST STE 201
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City | OAKLAND
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State | CA
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Zip | 94607-4206
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Country | US
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Telephone | 510-834-8386
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Fax | 510-834-3682
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Authorized Official
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Title or Position | DENTIST
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Name | DR. HAROLD K FUNG
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Credential | DMD
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Telephone | 510-504-4486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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