Healthcare Provider Details

I. General information

NPI: 1396984969
Provider Name (Legal Business Name): FRANK QUEI-CHUAN TANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2009
Last Update Date: 02/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40690 CALIF OAKS RD # A
MURRIETA CA
92562-5857
US

IV. Provider business mailing address

40690 CALIF OAKS RD # A
MURRIETA CA
92562-5857
US

V. Phone/Fax

Practice location:
  • Phone: 951-677-0098
  • Fax: 951-677-2017
Mailing address:
  • Phone: 951-677-0098
  • Fax: 951-677-2017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA38063
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA38063
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: