Provider Demographics
NPI:1649604497
Name:UNG, DIANA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:
Last Name:UNG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 PARNASSUS AVE
Mailing Address - Street 2:B1
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143
Mailing Address - Country:US
Mailing Address - Phone:415-353-2497
Mailing Address - Fax:415-353-2777
Practice Address - Street 1:400 PARNASSUS AVE
Practice Address - Street 2:B1
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143
Practice Address - Country:US
Practice Address - Phone:415-353-2497
Practice Address - Fax:415-353-2777
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-29
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69575183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist