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NPI Code Detail

MEDICARE: SUSAN TANG D.O.

MEDICARE: SUSAN TANG D.O.
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
1207Q00000XFamily Medicine Physician20A15492CA

General Provider Information

NPI Number : 1952780017
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN TANG D.O.
Provider Business Mailing Address
First Line : 100 S ANAHEIM BLVD STE 101
Second Line :
City : ANAHEIM
State : CA
Zip : 92805-3848
Country : US
Telephone Number : 714-826-1200
Fax Number : 714-665-4652
Provider Business Practice Location Address
First Line : 100 S ANAHEIM BLVD STE 101
Second Line :
City : ANAHEIM
State : CA
Zip : 92805-3848
Country : US
Telephone Number : 714-826-1200
Fax Number : 714-665-4652
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2015
Last Update Date : 01/29/2026

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Directions to “ SUSAN TANG D.O.” Practice Location

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