Provider Demographics
NPI:1275609349
Name:FANG, TZANN T (MD)
Entity Type:Individual
Prefix:
First Name:TZANN
Middle Name:T
Last Name:FANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15700 SW GREYSTONE CT
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-6011
Mailing Address - Country:US
Mailing Address - Phone:971-262-9000
Mailing Address - Fax:971-262-9010
Practice Address - Street 1:15700 SW GREYSTONE CT
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-6011
Practice Address - Country:US
Practice Address - Phone:971-262-9000
Practice Address - Fax:971-262-9010
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD202120207RX0202X
NHEL10705207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G26585Medicare UPIN
CA00A636431Medicaid
G26585Medicare UPIN