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General NPI Number Information
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NPI Number | 1457631269
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Entity Type | Individual
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Provider Name | ERIC YUANKER TUNG D.O.
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Gender | Male
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Dates
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Enumeration Date | 08/24/2011
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Last Update Date | 12/21/2022
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Provider Practice Location Address
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Address Line | 3020 CHILDRENS WAY MC 5018
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City | SAN DIEGO
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State | CA
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Zip | 92123
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Country | US
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Telephone | 858-966-7759
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Fax | 858-966-7525
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Provider Business Mailing Address
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Address Line | 4231 BALBOA AVE PMB 3066
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City | SAN DIEGO
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State | CA
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Zip | 92117-5504
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Country | US
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Telephone | 619-304-6469
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Fax | 425-249-3151
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 257366
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 20A13986
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License Number State | CA
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