Healthcare Provider Details

I. General information

NPI: 1245499045
Provider Name (Legal Business Name): JONELON GABRIEL TSANG MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2008
Last Update Date: 10/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 FOREST AVE STE 220A
SAN JOSE CA
95128
US

IV. Provider business mailing address

2101 FOREST AVE STE 220A
SAN JOSE CA
95128-1473
US

V. Phone/Fax

Practice location:
  • Phone: 408-295-8628
  • Fax: 408-295-8061
Mailing address:
  • Phone: 408-295-8628
  • Fax: 408-295-8061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA153286
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA153286
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: