Healthcare Provider Details

I. General information

NPI: 1760552640
Provider Name (Legal Business Name): DIANA TANG, M.D. AND SONJA HUIE, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 10/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 CALIFORNIA ST STE 100
SAN FRANCISCO CA
94109
US

IV. Provider business mailing address

1700 CALIFORNIA ST STE 100
SAN FRANCISCO CA
94109-4587
US

V. Phone/Fax

Practice location:
  • Phone: 415-440-6700
  • Fax: 415-440-6707
Mailing address:
  • Phone: 415-440-6700
  • Fax: 415-440-6707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DIANA G. TANG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 415-440-6700