Healthcare Provider Details

I. General information

NPI: 1902916257
Provider Name (Legal Business Name): JOHN SHIU-MING TANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 PACIFIC AVE STE 300
SAN FRANCISCO CA
94133-4449
US

IV. Provider business mailing address

728 PACIFIC AVE STE 300
SAN FRANCISCO CA
94133-4449
US

V. Phone/Fax

Practice location:
  • Phone: 415-781-2598
  • Fax: 415-781-2412
Mailing address:
  • Phone: 415-781-2598
  • Fax: 415-781-2412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberG34756
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: