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General NPI Number Information
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NPI Number | 1225800147
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Entity Type | Individual
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Provider Name | KIMBERLY KEELY TANG PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/24/2023
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 505 CITY PKWY W
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City | ORANGE
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State | CA
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Zip | 92868-2924
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Country | US
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Telephone | 657-900-1149
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Fax | 714-954-2239
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Provider Business Mailing Address
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Address Line | 505 CITY PKWY W
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City | ORANGE
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State | CA
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Zip | 92868-2924
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Country | US
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Telephone | 657-900-1149
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Fax | 714-954-2239
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 85243
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License Number State | CA
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