Healthcare Provider Details

I. General information

NPI: 1558363978
Provider Name (Legal Business Name): DEBORAH DANG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 12/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1333 BUSH ST
SAN FRANCISCO CA
94109-5611
US

IV. Provider business mailing address

1 KOFMAN CT
ALAMEDA CA
94502-7400
US

V. Phone/Fax

Practice location:
  • Phone: 415-292-8888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberC41766
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: