Provider Demographics
NPI:1396911608
Name:VINCENT C HUNG MD, INC
Entity type:Organization
Organization Name:VINCENT C HUNG MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:C
Authorized Official - Last Name:HUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-432-5032
Mailing Address - Street 1:452 N ALTADENA DRIVE
Mailing Address - Street 2:200
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-2536
Mailing Address - Country:US
Mailing Address - Phone:626-432-5032
Mailing Address - Fax:626-432-5030
Practice Address - Street 1:452 N ALTADENA DRIVE
Practice Address - Street 2:200
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-2563
Practice Address - Country:US
Practice Address - Phone:626-432-5032
Practice Address - Fax:626-432-5030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG40766174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA48344Medicare UPIN