Provider Demographics
NPI:1619344918
Name:TSANG, DARWIN C (OD)
Entity Type:Individual
Prefix:DR
First Name:DARWIN
Middle Name:C
Last Name:TSANG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:707 KENILWORTH DRIVE
Mailing Address - Street 2:INSIDE TARGET OPTICAL
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-3400
Mailing Address - Country:US
Mailing Address - Phone:707-782-0572
Mailing Address - Fax:707-782-0568
Practice Address - Street 1:401 KENILWORTH DR
Practice Address - Street 2:INSIDE TARGET OPTICAL
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-3400
Practice Address - Country:US
Practice Address - Phone:707-775-6022
Practice Address - Fax:707-782-0568
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-21
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15225 TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist