Healthcare Provider Details

I. General information

NPI: 1124997697
Provider Name (Legal Business Name): STEVEN TANG PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 S AVENUE A
YUMA AZ
85364-7127
US

IV. Provider business mailing address

8923 LAGUNA FLS
SAN ANTONIO TX
78251-4958
US

V. Phone/Fax

Practice location:
  • Phone: 928-336-2000
  • Fax:
Mailing address:
  • Phone: 928-336-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835E0208X
TaxonomyEmergency Medicine Pharmacist
License NumberS027697
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: