Active NPI
Frederick Y Fung, M.D.
- Occupational Medicine Physician
- San Diego, CA
National Provider Identifier
1033129127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Medicine Physician
- License
- A40644
- Practice address
- 300 Fir St
San Diego, CA 92101-2327 - Phone
- (619) 446-1510
- Fax
- (619) 446-1514
- NPI assigned
- Aug 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Toxicology (Preventive Medicine) Physician | 2083T0002X | A40644 | CA | |
| Occupational Medicine Physician | 2083X0100X | A40644 | CA | Primary |
Addresses
Primary practice location
300 Fir St
San Diego, CA 92101-2327
Mailing address
300 Fir St
San Diego, CA 92101-2327
Phone (619) 446-1510
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A406440 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40644 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371600000000",
"number": "1033129127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 FIR ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921012327",
"telephone_number": "619-446-1510",
"fax_number": "619-446-1514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 FIR ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921012327",
"telephone_number": "619-446-1510",
"fax_number": "619-446-1514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUNG",
"first_name": "FREDERICK",
"middle_name": "Y",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-09",
"last_updated": "2013-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "2083T0002X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Medical Toxicology",
"state": "CA",
"license": "A40644",
"primary": false
},
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "CA",
"license": "A40644",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A406440",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.