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General NPI Number Information
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NPI Number | 1003251687
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Entity Type | Organization
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Legal Business Name | SANG MEDICAL CORP
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Dates
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Enumeration Date | 05/08/2013
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Last Update Date | 07/07/2014
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Provider Practice Location Address
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Address Line | 1122 S ST
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City | FRESNO
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State | CA
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Zip | 93721-1430
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Country | US
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Telephone | 559-268-1737
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Fax | 559-268-1738
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Provider Business Mailing Address
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Address Line | 1122 S ST SUITE 102
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City | FRESNO
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State | CA
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Zip | 93721-1430
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Country | US
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Telephone | 559-268-1737
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Fax | 559-268-1738
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Authorized Official
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Title or Position | OWNER
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Name | DR. NEW SANG
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Credential | M.D.
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Telephone | 559-268-1737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A93522
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License Number State | CA
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