Healthcare Provider Details

I. General information

NPI: 1326133042
Provider Name (Legal Business Name): EDWARD TANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6235 N FRESNO ST SUITE # 103
FRESNO CA
93710-5269
US

IV. Provider business mailing address

6235 N FRESNO ST STE 103
FRESNO CA
93710-5269
US

V. Phone/Fax

Practice location:
  • Phone: 559-449-4350
  • Fax: 559-449-4358
Mailing address:
  • Phone: 559-449-4350
  • Fax: 559-449-4358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD29107
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG69085
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberC5131
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD-56283
License Number StateIA
# 5
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME156447
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberC5131
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: