Healthcare Provider Details

I. General information

NPI: 1275858821
Provider Name (Legal Business Name): CATHY JOYCE TANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2010
Last Update Date: 05/07/2024
Certification Date: 01/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S MANCHESTER AVE STE 650
ORANGE CA
92868-3224
US

IV. Provider business mailing address

200 S MANCHESTER AVE STE 650
ORANGE CA
92868-3224
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-3077
  • Fax:
Mailing address:
  • Phone: 714-456-3077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA118948
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: