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General NPI Number Information
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NPI Number | 1346656055
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Entity Type | Individual
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Provider Name | ANDREW TANG NP
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Gender | Male
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Dates
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Enumeration Date | 07/02/2014
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Last Update Date | 06/22/2015
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Provider Practice Location Address
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Address Line | 14777 LOS GATOS BLVD STE 202
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City | LOS GATOS
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State | CA
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Zip | 95032-2059
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Country | US
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Telephone | 408-528-8833
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Fax |
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Provider Business Mailing Address
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Address Line | 14777 LOS GATOS BLVD STE 202
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City | LOS GATOS
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State | CA
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Zip | 95032-2059
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Country | US
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Telephone | 408-528-8833
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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 | 95000455
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License Number State | CA
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