Provider Demographics
NPI:1710103783
Name:FRANK QUEI-CHUAN,TANG MD.FAAP.INC.
Entity Type:Organization
Organization Name:FRANK QUEI-CHUAN,TANG MD.FAAP.INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:Q
Authorized Official - Last Name:TANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-677-0098
Mailing Address - Street 1:40690 CALIFORNIA OAKS RD # A
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5857
Mailing Address - Country:US
Mailing Address - Phone:951-677-0098
Mailing Address - Fax:
Practice Address - Street 1:40690 CALIFORNIA OAKS RD # A
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5857
Practice Address - Country:US
Practice Address - Phone:951-677-0098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38063174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A380630Medicaid
CA00A380630Medicaid
CA00A380630Medicare ID - Type Unspecified