Provider Demographics
NPI:1487863395
Name:CT HUNG MD INC.
Entity Type:Organization
Organization Name:CT HUNG MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARADISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-985-2709
Mailing Address - Street 1:629 N 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4906
Mailing Address - Country:US
Mailing Address - Phone:909-985-2709
Mailing Address - Fax:909-985-3688
Practice Address - Street 1:629 N 13TH AVE
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4906
Practice Address - Country:US
Practice Address - Phone:909-985-2709
Practice Address - Fax:909-985-3688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00A363360174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty