Healthcare Provider Details

I. General information

NPI: 1902743867
Provider Name (Legal Business Name): YU PANG TANG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 E HAMILTON AVE STE 6
CAMPBELL CA
95008-0263
US

IV. Provider business mailing address

10455 CORTE DE SEVILLE
CUPERTINO CA
95014-3407
US

V. Phone/Fax

Practice location:
  • Phone: 408-871-2838
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number20601
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: