Provider Demographics
NPI:1619913720
Name:TUNG, SING LONG (MD)
Entity Type:Individual
Prefix:MR
First Name:SING
Middle Name:LONG
Last Name:TUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 S BRISTOL
Mailing Address - Street 2:202
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704
Mailing Address - Country:US
Mailing Address - Phone:714-754-0498
Mailing Address - Fax:714-754-0494
Practice Address - Street 1:2621 S BRISTOL
Practice Address - Street 2:202
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704
Practice Address - Country:US
Practice Address - Phone:714-754-0498
Practice Address - Fax:714-754-0494
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD33253207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A332530OtherMEDI CAL
CA00A332530OtherMEDI CAL
CA133253Medicare ID - Type Unspecified