MEDICARE: ANDREA K KUNG M.D.

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	A53319	CA

General Provider Information

NPI Number	:	1932105582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA K KUNG M.D.

Provider Business Mailing Address
First Line	:	1441 POWELL ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94133-3848
Country	:	US
Telephone Number	:
Fax Number	:	415-292-8666

Provider Business Practice Location Address
First Line	:	1441 POWELL ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94133-3848
Country	:	US
Telephone Number	:	415-292-8687
Fax Number	:	415-292-8666

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

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	01/24/2011

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