Provider Demographics
NPI:1962449538
Name:FUNG, PETER C (MD, FACP)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:C
Last Name:FUNG
Suffix:
Gender:M
Credentials:MD, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 E ARQUES AVE STE 113
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-5419
Mailing Address - Country:US
Mailing Address - Phone:408-738-9728
Mailing Address - Fax:408-738-9730
Practice Address - Street 1:1208 E ARQUES AVE
Practice Address - Street 2:SUITE 113
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-5418
Practice Address - Country:US
Practice Address - Phone:408-738-9728
Practice Address - Fax:408-738-9730
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA307232084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A307232Medicare PIN
CAA26206Medicare UPIN