Provider Demographics
NPI:1992336366
Name:TUNG, JOSHWINDER SINGH
Entity type:Individual
Prefix:
First Name:JOSHWINDER
Middle Name:SINGH
Last Name:TUNG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1651 BELLEVUE RD
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-2608
Mailing Address - Country:US
Mailing Address - Phone:209-358-3304
Mailing Address - Fax:
Practice Address - Street 1:1651 BELLEVUE RD
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-2608
Practice Address - Country:US
Practice Address - Phone:209-358-3304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA80699183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist