MEDICARE: DR. JIMMY TANG HANG PT, DPT, CSCS

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	225100000X	Physical Therapist	PT28952	CA
2	2251G0304X	Geriatric Physical Therapist	PT28952	CA
3	2251H1300X	Human Factors Physical Therapist	PT28952	CA
4	2251N0400X	Neurology Physical Therapist	PT28952	CA
5	2251S0007X	Sports Physical Therapist	PT28952	CA
6	2251X0800X	Orthopedic Physical Therapist	PT28952	CA

General Provider Information

NPI Number	:	1508881145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JIMMY TANG HANG PT, DPT, CSCS

Provider Business Mailing Address
First Line	:	PO BOX 171
Second Line	:
City	:	CLAREMONT
State	:	CA
Zip	:	91711-0171
Country	:	US
Telephone Number	:	626-236-3905
Fax Number	:

Provider Business Practice Location Address
First Line	:	41 N GARFIELD AVE
Second Line	:	SUITE 102
City	:	ALHAMBRA
State	:	CA
Zip	:	91801-3556
Country	:	US
Telephone Number	:	626-236-3905
Fax Number	:

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

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	01/07/2013

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