Healthcare Provider Details

I. General information

NPI: 1063720217
Provider Name (Legal Business Name): DAVID J. LANG,MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2010
Last Update Date: 09/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

359 SAN MIGUEL DR SUITE 206
NEWPORT BEACH CA
92660-7812
US

IV. Provider business mailing address

2117 VICTORIA DR
SANTA ANA CA
92706
US

V. Phone/Fax

Practice location:
  • Phone: 949-706-2751
  • Fax:
Mailing address:
  • Phone: 714-478-2140
  • Fax: 949-706-2761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG50878
License Number StateCA

VIII. Authorized Official

Name: MRS. PATRICIA M LEMUS
Title or Position: OFFICE MANAGER
Credential: CMA
Phone: 949-706-2751