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General NPI Number Information
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NPI Number | 1649324120
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Entity Type | Organization
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Legal Business Name | CENTRAL BRISTOL MEDICAL GROUP INC
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1155 W CENTRAL AVE SUITE 108
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City | SANTA ANA
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State | CA
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Zip | 92707
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Country | US
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Telephone | 714-241-8162
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Fax | 714-241-8163
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Provider Business Mailing Address
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Address Line | 1155 W CENTRAL AVE SUITE 108
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City | SANTA ANA
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State | CA
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Zip | 92707
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Country | US
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Telephone | 714-241-8162
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Fax | 714-241-8163
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Authorized Official
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Title or Position | OWNER
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Name | NHIEP TANG
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Credential | MD
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Telephone | 714-241-8162
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | A37133
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A36670
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License Number State | CA
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