Healthcare Provider Details

I. General information

NPI: 1306194915
Provider Name (Legal Business Name): TANGEL CHANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2012
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15400 NATIONAL AVE STE 100
LOS GATOS CA
95032-2433
US

IV. Provider business mailing address

5 HARRIS CT STE 201
MONTEREY CA
93940-5750
US

V. Phone/Fax

Practice location:
  • Phone: 408-358-8400
  • Fax: 408-358-2793
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number1306194915
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number20A13213
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number34.012242
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: