Provider Demographics
NPI:1457631269
Name:TUNG, ERIC YUANKER (DO)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:YUANKER
Last Name:TUNG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4231 BALBOA AVE
Mailing Address - Street 2:PMB 3066
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-5504
Mailing Address - Country:US
Mailing Address - Phone:619-304-6469
Mailing Address - Fax:425-249-3151
Practice Address - Street 1:3020 CHILDRENS WAY
Practice Address - Street 2:MC 5018
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123
Practice Address - Country:US
Practice Address - Phone:858-966-7759
Practice Address - Fax:858-966-7525
Is Sole Proprietor?:No
Enumeration Date:2011-08-24
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2573662084P0800X
CA20A139862084P0804X
MA248493390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program