Provider Demographics
NPI:1417911462
Name:FANG, MARGARET C (MD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:C
Last Name:FANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 PARNASSUS AVE.
Mailing Address - Street 2:BOX 0131
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0131
Mailing Address - Country:US
Mailing Address - Phone:415-502-1414
Mailing Address - Fax:415-514-2094
Practice Address - Street 1:533 PARNASSUS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2208
Practice Address - Country:US
Practice Address - Phone:415-502-1414
Practice Address - Fax:415-514-2094
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83381207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0A8338100Medicaid
CA0A8338100Medicaid
CAH36309Medicare UPIN