Basic Information
Provider Information
NPI: 1871931584
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FUNG
FirstName: MONICA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D., M.P.H
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 400 PARNASSUS AVE
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941432202
CountryCode: US
TelephoneNumber: 4153532626
FaxNumber:  
Practice Location
Address1: 400 PARNASSUS AVE
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941432202
CountryCode: US
TelephoneNumber: 4153532626
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/05/2013
LastUpdateDate: 12/19/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/19/2019

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RI0200XA142212CAY Allopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease

No ID Information.


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