Provider Demographics
NPI:1992852131
Name:FUNG, HANK K (M)
Entity Type:Individual
Prefix:
First Name:HANK
Middle Name:K
Last Name:FUNG
Suffix:
Gender:M
Credentials:M
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5924 STONERIDGE DR
Mailing Address - Street 2:STE 101
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-2750
Mailing Address - Country:US
Mailing Address - Phone:925-426-8828
Mailing Address - Fax:925-426-8812
Practice Address - Street 1:5924 STONERIDGE DR
Practice Address - Street 2:STE 101
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-2750
Practice Address - Country:US
Practice Address - Phone:925-426-8828
Practice Address - Fax:925-426-8812
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2017-12-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA61143207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
5W234Medicare ID - Type Unspecified
G06168Medicare UPIN