Doctor Name: | DR. DAVID FUNG DER |
NPI Number: | 1871606707 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | G9021 |
Business Practice Address: | 817 Harrison St Oakland, CA - 946074422 |
Business Phone Number: | 5104518088 |
Business Fax Number: | 5104516360 |
Mailing Address: | 817 Harrison St, OAKLAND |
State: | CA |
Postal Code: | 946074422 |
Phone Number: | 5104518088 |
Fax Number: | 5104516360 |
NPI Enumeration Date: | 08/16/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | G9021 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |