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General NPI Number Information
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NPI Number | 1720007792
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Entity Type | Individual
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Provider Name | CONSTANCE HUIKONG FUNG MD
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Gender | Female
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 07/26/2011
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Provider Practice Location Address
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Address Line | 16111 PLUMMER STREET 11E
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City | NORTH HILLS
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State | CA
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Zip | 91343
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Country | US
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Telephone | 310-478-3711
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Fax |
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Provider Business Mailing Address
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Address Line | 16111 PLUMMER STREET 11E
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City | NORTH HILLS
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State | CA
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Zip | 91343
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Country | US
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Telephone | 310-478-3711
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A70667
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | A70667
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License Number State | CA
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