Provider Demographics
NPI:1154688133
Name:DANG, DAVID (CASE MANAGER)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:DANG
Suffix:
Gender:M
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15400 SHERMAN WAY # 220
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-4271
Mailing Address - Country:US
Mailing Address - Phone:818-267-1100
Mailing Address - Fax:213-383-3146
Practice Address - Street 1:15400 SHERMAN WAY # 220
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-4271
Practice Address - Country:US
Practice Address - Phone:818-267-1100
Practice Address - Fax:213-383-3146
Is Sole Proprietor?:No
Enumeration Date:2012-04-16
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator