MEDICARE: DR. JENNIFER HUNG D.O.

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	207R00000X	Internal Medicine Physician	20A8642	CA

General Provider Information

NPI Number	:	1528118395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER HUNG D.O.

Provider Business Mailing Address
First Line	:	2240 MERCURY WAY
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95407-5413
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2240 MERCURY WAY
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95407-5413
Country	:	US
Telephone Number	:	707-687-6125
Fax Number	:

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

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	04/02/2024

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