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General NPI Number Information
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NPI Number | 1073019881
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Entity Type | Individual
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Provider Name | JENNIFER CHIWING TANG MD
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Gender | Female
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Dates
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Enumeration Date | 04/02/2018
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 1200 N STATE ST. CLINIC TOWER, SUITE A7D
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City | LOS ANGELES
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State | CA
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Zip | 90033-1029
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Country | US
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Telephone | 323-226-7556
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Fax |
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Provider Business Mailing Address
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Address Line | 827 CAMINO RICARDO
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City | MORAGA
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State | CA
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Zip | 94556-1222
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Country | US
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Telephone | 925-787-1553
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A164469
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 327870
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 327870
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License Number State | NY
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