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General NPI Number Information
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NPI Number | 1376963199
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Entity Type | Individual
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Provider Name | ABRAHAM TANG
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Gender | Male
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Dates
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Enumeration Date | 04/19/2014
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 2233 E GARVEY AVE N STE B
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City | WEST COVINA
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State | CA
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Zip | 91791-1500
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Country | US
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Telephone | 626-412-0200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 270061
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City | SAN DIEGO
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State | CA
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Zip | 92198-2061
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Country | US
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Telephone | 760-705-8264
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 100165
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License Number State | CA
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