Provider Demographics
NPI:1487234860
Name:TUNG, SPENCER (MD)
Entity type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:
Last Name:TUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SHIN PU
Other - Middle Name:
Other - Last Name:TUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:315 MERCY AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-8363
Mailing Address - Country:US
Mailing Address - Phone:209-564-3500
Mailing Address - Fax:
Practice Address - Street 1:1000 FRANKLIN PKWY
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-1922
Practice Address - Country:US
Practice Address - Phone:650-358-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-10
Last Update Date:2024-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA193175207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine