Healthcare Provider Details

I. General information

NPI: 1982261178
Provider Name (Legal Business Name): GEORGE TANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2019
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 HAWTHORNE AVE STE 201
OAKLAND CA
94609-3114
US

IV. Provider business mailing address

PO BOX 276950
SACRAMENTO CA
95827-6950
US

V. Phone/Fax

Practice location:
  • Phone: 510-204-8383
  • Fax:
Mailing address:
  • Phone: 510-204-8383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA182535
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: