Provider Demographics
NPI:1316901101
Name:FUNG, MAPLE M (MD)
Entity type:Individual
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First Name:MAPLE
Middle Name:M
Last Name:FUNG
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Gender:F
Credentials:MD
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Mailing Address - Street 1:4225 EXECUTIVE SQ STE 450
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-8411
Mailing Address - Country:US
Mailing Address - Phone:858-810-8000
Mailing Address - Fax:858-268-1911
Practice Address - Street 1:4060 FOURTH AVE STE 220
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2120
Practice Address - Country:US
Practice Address - Phone:619-299-2350
Practice Address - Fax:619-297-8379
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2024-11-19
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Provider Licenses
StateLicense IDTaxonomies
CAA76595207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology