Provider Demographics
NPI:1609884758
Name:TANG, ANGELA WAILAN (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:WAILAN
Last Name:TANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:26 EMPTY SADDLE LN
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-4118
Mailing Address - Country:US
Mailing Address - Phone:562-491-9350
Mailing Address - Fax:562-491-9146
Practice Address - Street 1:1050 LINDEN AVE
Practice Address - Street 2:DEPARTMENT OF MEDICAL EDUCATION
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-3321
Practice Address - Country:US
Practice Address - Phone:562-491-9350
Practice Address - Fax:562-491-9146
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGO78229207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH30724Medicare UPIN