Individual
DR. DIANNA MUNG-FUNG MAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
9089 BASELINE ROAD, SUITE 100, RANCHO CUCAMONGA, CA 91730
(909) 483-0505
(909) 483-0508
Mailing address
9089 BASELINE ROAD, SUITE 100, RANCHO CUCAMONGA, CA 91730
(909) 483-0505
(909) 483-0508
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A5237
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX52370
—
CA
01
—
P00148996
RR MEDICARE
CA
Enumeration date
08/30/2006
Last updated
01/11/2024
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