Doctor Name: | ROBERT EDWARD TANG |
NPI Number: | 1245247048 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.M. |
License Number: | E3983 |
Business Practice Address: | 560 Jenevein Ave San Bruno, CA - 940664408 |
Business Phone Number: | 6505889189 |
Business Fax Number: | 6505882814 |
Mailing Address: | 560 Jenevein Ave, SAN BRUNO |
State: | CA |
Postal Code: | 940664408 |
Phone Number: | 6505889189 |
Fax Number: | 6505882814 |
NPI Enumeration Date: | 08/02/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | E3983 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |