MEDICARE: CHRISTOPHER TUNG DMD

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
1	122300000X	Dentist	63125	CA
2	122300000X	Dentist	DE60417176	WA

General Provider Information

NPI Number	:	1306277934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER TUNG DMD

Provider Business Mailing Address
First Line	:	4090 N CHESTNUT AVE
Second Line	:	APT 201
City	:	FRESNO
State	:	CA
Zip	:	93726-4707
Country	:	US
Telephone Number	:	206-856-1411
Fax Number	:

Provider Business Practice Location Address
First Line	:	16510 CLEVELAND ST
Second Line	:	SUITE Q
City	:	REDMOND
State	:	WA
Zip	:	98052-4439
Country	:	US
Telephone Number	:	425-882-1112
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2013
Last Update Date	:	12/12/2013

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