Individual provider Active NPI

Watson Kong Yung Tung, O.M.D., LAC

  • Acupuncturist
  • Corona del Mar, CA
National Provider Identifier
1174784698
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC1582 Issued in CA
Practice address
2865 E Coast Hwy
Ste 206
Corona del Mar, CA 92625-2236
Phone
(949) 673-0145
Fax
(949) 723-7632
NPI assigned
Jun 18, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC1582 CA Primary

Addresses

Primary practice location

2865 E Coast Hwy
Ste 206
Corona del Mar, CA 92625-2236

Mailing address

2865 E Coast Hwy
Ste 206
Corona del Mar, CA 92625-2236
Phone (949) 673-0145

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AC1582CAMDAcupuncturist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1174784698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 E COAST HWY",
            "address_2": "STE 206",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926252236",
            "telephone_number": "949-673-0145",
            "fax_number": "949-723-7632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 E COAST HWY",
            "address_2": "STE 206",
            "city": "CORONA DEL MAR",
            "state": "CA",
            "postal_code": "926252236",
            "telephone_number": "949-673-0145",
            "fax_number": "949-723-7632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUNG",
        "first_name": "WATSON",
        "middle_name": "KONG YUNG",
        "name_prefix": "Mr.",
        "credential": "O.M.D., LAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-18",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC1582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona del Mar, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.