Provider Demographics
NPI:1174784698
Name:TUNG, WATSON KONG YUNG (OMD, LAC)
Entity type:Individual
Prefix:MR
First Name:WATSON
Middle Name:KONG YUNG
Last Name:TUNG
Suffix:
Gender:M
Credentials:OMD, LAC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2865 E COAST HWY
Mailing Address - Street 2:STE 206
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-2236
Mailing Address - Country:US
Mailing Address - Phone:949-673-0145
Mailing Address - Fax:949-723-7632
Practice Address - Street 1:2865 E COAST HWY
Practice Address - Street 2:STE 206
Practice Address - City:CORONA DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92625-2236
Practice Address - Country:US
Practice Address - Phone:949-673-0145
Practice Address - Fax:949-723-7632
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC1582171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist