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NPI Code Detail

MEDICARE: SHI TANG

MEDICARE: SHI TANG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1023695814
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHI TANG
Provider Business Mailing Address
First Line : 560 W MAIN ST STE C
Second Line :
City : ALHAMBRA
State : CA
Zip : 91801-3376
Country : US
Telephone Number : 840-465-2899
Fax Number :
Provider Business Practice Location Address
First Line : 20301 VENTURA BLVD STE 210
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91364-0934
Country : US
Telephone Number : 818-346-4300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2021
Last Update Date : 03/18/2026

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Directions to “ SHI TANG ” Practice Location

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