Healthcare Provider Details

I. General information

NPI: 1467192260
Provider Name (Legal Business Name): JOHNNY DANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 06/21/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 QUARRY RD
PALO ALTO CA
94304-1416
US

IV. Provider business mailing address

9836 ACACIA AVE APT A
GARDEN GROVE CA
92841-7214
US

V. Phone/Fax

Practice location:
  • Phone: 650-723-6469
  • Fax:
Mailing address:
  • Phone: 714-251-2062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: