Provider Demographics
NPI:1952862203
Name:TUNG, CAMIE (LAC)
Entity Type:Individual
Prefix:MR
First Name:CAMIE
Middle Name:
Last Name:TUNG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4675 CENTRAL PLZ
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-6417
Mailing Address - Country:US
Mailing Address - Phone:858-216-6626
Mailing Address - Fax:
Practice Address - Street 1:4675 CENTRAL PLZ
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-6417
Practice Address - Country:US
Practice Address - Phone:858-216-6626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AC13987171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist