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NPI Code Detail

MEDICARE: MR. JAMES FUNG D.O. , M.P.H.

MEDICARE: MR. JAMES FUNG D.O. , M.P.H.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician20A22146CA

General Provider Information

NPI Number : 1114579661
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAMES FUNG D.O. , M.P.H.
Provider Business Mailing Address
First Line : PO BOX 7410882
Second Line :
City : CHICAGO
State : IL
Zip : 60674-0882
Country : US
Telephone Number : 800-598-9908
Fax Number : 702-977-1496
Provider Business Practice Location Address
First Line : 2221 LINCOLN PARK AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-2920
Country : US
Telephone Number : 312-635-0973
Fax Number : 312-635-0050
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2019
Last Update Date : 09/18/2025

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