Provider Demographics
NPI:1437448206
Name:HUNG, TAN KI (RD)
Entity Type:Individual
Prefix:MS
First Name:TAN
Middle Name:KI
Last Name:HUNG
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MS
Other - First Name:SOPHIE
Other - Middle Name:
Other - Last Name:HUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:600 N GARFIELD AVE STE 311
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1171
Mailing Address - Country:US
Mailing Address - Phone:626-476-5006
Mailing Address - Fax:
Practice Address - Street 1:600 N GARFIELD AVE STE 311
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1171
Practice Address - Country:US
Practice Address - Phone:626-476-5006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1059517133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered