Healthcare Provider Details

I. General information

NPI: 1518718105
Provider Name (Legal Business Name): NANCY TANG N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2024
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 5TH AVE STE 110
SAN DIEGO CA
92103-3122
US

IV. Provider business mailing address

6971 EL CAMINO REAL STE 101
CARLSBAD CA
92009-4114
US

V. Phone/Fax

Practice location:
  • Phone: 858-554-1212
  • Fax:
Mailing address:
  • Phone: 760-258-4971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number9502953
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95029532
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: