MEDICARE: MRS. IRENE SU TANG KNIGHT NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	95016253	CA

General Provider Information

NPI Number	:	1356923205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. IRENE SU TANG KNIGHT NP

Provider Business Mailing Address
First Line	:	29370 LAS BRISAS RD
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91354-1533
Country	:	US
Telephone Number	:	661-607-7737
Fax Number	:

Provider Business Practice Location Address
First Line	:	29370 LAS BRISAS RD
Second Line	:
City	:	SANTA CLARITA
State	:	CA
Zip	:	91354-1533
Country	:	US
Telephone Number	:	661-607-7737
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2021
Last Update Date	:	04/21/2021

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