Provider Demographics
NPI:1336494590
Name:TANG, PATRICIA B (OD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:B
Last Name:TANG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1724 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-4424
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:53 COLMA BLVD
Practice Address - Street 2:
Practice Address - City:COLMA
Practice Address - State:CA
Practice Address - Zip Code:94014-3231
Practice Address - Country:US
Practice Address - Phone:650-992-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14477152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist