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General NPI Number Information
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NPI Number | 1740423888
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Entity Type | Organization
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Legal Business Name | MAO H. HUNG,M.D.,A MEDICAL CORPORATION
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Dates
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Enumeration Date | 04/17/2009
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Last Update Date | 04/17/2009
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Provider Practice Location Address
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Address Line | 313 E BUENA VISTA ST STE 103
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City | BARSTOW
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State | CA
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Zip | 92311-2861
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Country | US
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Telephone | 760-256-7134
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Fax |
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Provider Business Mailing Address
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Address Line | 313 E BUENA VISTA ST STE 103
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City | BARSTOW
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State | CA
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Zip | 92311-2861
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Country | US
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Telephone | 760-256-7134
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MAO H HUNG
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Credential | M.D.
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Telephone | 760-256-7134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | A30974
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License Number State | CA
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