Provider Demographics
NPI:1407939465
Name:KUNG, MEI PO (MD)
Entity Type:Individual
Prefix:DR
First Name:MEI
Middle Name:PO
Last Name:KUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 ESTUDILLO AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4723
Mailing Address - Country:US
Mailing Address - Phone:510-315-7196
Mailing Address - Fax:510-315-8715
Practice Address - Street 1:237 ESTUDILLO AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4725
Practice Address - Country:US
Practice Address - Phone:510-315-7196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA74051207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A740510Medicaid
CAG77605Medicare UPIN
CA00A740510Medicaid
CA00A740510Medicare PIN