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General NPI Number Information
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NPI Number | 1720615792
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Entity Type | Individual
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Provider Name | JAMES PANG
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Gender | Male
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Dates
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Enumeration Date | 03/26/2020
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Last Update Date | 04/16/2024
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Provider Practice Location Address
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Address Line | 1512 S DE ANZA BLVD
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City | SAN JOSE
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State | CA
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Zip | 95129-4606
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Country | US
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Telephone | 408-461-7676
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Fax |
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Provider Business Mailing Address
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Address Line | 11131 CHADWICK PL
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City | CUPERTINO
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State | CA
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Zip | 95014-4705
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Country | US
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Telephone | 617-959-1733
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT293301
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License Number State | CA
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