Healthcare Provider Details

I. General information

NPI: 1407993595
Provider Name (Legal Business Name): GEXIN AND ASSOCIATES, A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 11/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15825 LAGUNA CANYON RD STE 100
IRVINE CA
92618-2126
US

IV. Provider business mailing address

5 HOLLAND SUITE 101
IRVINE CA
92618-2568
US

V. Phone/Fax

Practice location:
  • Phone: 949-679-6700
  • Fax: 949-387-9530
Mailing address:
  • Phone: 949-588-2190
  • Fax: 949-588-2199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA69406
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number69406
License Number StateCA

VIII. Authorized Official

Name: DR. GEXIN TANG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 949-836-1888