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General NPI Number Information
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NPI Number | 1134591944
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Entity Type | Individual
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Provider Name | TEDDY DANG
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Gender | Male
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Dates
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Enumeration Date | 10/21/2015
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Last Update Date | 10/21/2015
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Provider Practice Location Address
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Address Line | 1000 W CARSON ST
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City | TORRANCE
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State | CA
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Zip | 90502-2004
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Country | US
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Telephone | 310-222-3241
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Fax |
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Provider Business Mailing Address
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Address Line | 22712 DOBLE AVE
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City | TORRANCE
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State | CA
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Zip | 90502-2310
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Country | US
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Telephone | 310-938-9070
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 702272
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License Number State | CA
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