David Allen Fung, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

414 Issued in MA

Practice address

131 Old Road to 9 Acre Cor
Suite 610
Concord, MA 01742-4181

Phone

(978) 371-7778

Fax

(978) 369-8514

NPI assigned

Apr 3, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366563603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 EXETER ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024783648",
            "telephone_number": "617-484-5894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 OLD ROAD TO 9 ACRE COR",
            "address_2": "SUITE 610",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017424181",
            "telephone_number": "978-371-7778",
            "fax_number": "978-369-8514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNG",
        "first_name": "DAVID",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frederick G Lea
• Lisa Fredman
• Jeffrey B Freedman, DDS
• Aaron L. Frenz, M.D.
• Andrea Fribush, M.D.
• Julie Gage, MS, CCC-SLP
• Elizabeth Galligan, LICSW
• Heather S Gangloff, PA
• Brian Patrick Ganley, DMD
• Kyle Taylor Ganson, LICSW

• Medical Physician Assistant in Concord, MA
• Providers in Concord, MA by specialty
• Medical Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.