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1871996512
GLORY FUNG
IRVINE, CA
NPI
1871996512
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: CA 070302088)
Enumeration Date
2014-10-08
Last Update Date
2014-10-08
Business Address
-- GLORY FUNG ATC
1530 CONCORDIA
IRVINE, CA 92612-3203
Phone number: 949-214-3245
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Mailing Address
-- GLORY FUNG ATC
1530 CONCORDIA
IRVINE, CA 92612-3203
Phone number: 949-214-3245
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