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General NPI Number Information
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NPI Number | 1841725686
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Entity Type | Individual
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Provider Name | KAI EN TANG D.O
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Gender | Female
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Dates
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Enumeration Date | 05/01/2017
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Last Update Date | 03/06/2024
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Provider Practice Location Address
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Address Line | 1530 HILLHURST AVE
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City | LOS ANGELES
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State | CA
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Zip | 90027-5516
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Country | US
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Telephone | 323-644-3880
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Fax | 323-660-0935
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Provider Business Mailing Address
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Address Line | 1025 PENNOCK PLACE FAMILY MEDICINE CENTER
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City | FORT COLLINS
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State | CO
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Zip | 80524
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Country | US
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Telephone | 858-926-8993
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 18297
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License Number State | CA
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