Provider Demographics
NPI:1316359581
Name:DANG, DAVID THANH (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:THANH
Last Name:DANG
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 1:1044 S FAIR OAKS AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2622
Mailing Address - Country:US
Mailing Address - Phone:626-334-0640
Mailing Address - Fax:888-658-9881
Practice Address - Street 1:1044 S FAIR OAKS AVE STE 101
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2622
Practice Address - Country:US
Practice Address - Phone:626-344-0640
Practice Address - Fax:888-658-9881
Is Sole Proprietor?:No
Enumeration Date:2014-05-22
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA133218207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine