Provider Demographics
NPI:1477821015
Name:TANG, LAYHEANG (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LAYHEANG
Middle Name:
Last Name:TANG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5829 LAKEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-1001
Mailing Address - Country:US
Mailing Address - Phone:562-817-5690
Mailing Address - Fax:562-817-5698
Practice Address - Street 1:5829 LAKEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-1001
Practice Address - Country:US
Practice Address - Phone:562-817-5690
Practice Address - Fax:562-817-5698
Is Sole Proprietor?:No
Enumeration Date:2011-12-11
Last Update Date:2011-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58861183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA183500000XOtherPHARMACY SERVICES