Provider Demographics
NPI:1750478681
Name:LI, GANG (MD)
Entity Type:Individual
Prefix:DR
First Name:GANG
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 S BASCOM AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-7300
Mailing Address - Country:US
Mailing Address - Phone:408-356-5292
Mailing Address - Fax:408-356-5307
Practice Address - Street 1:3425 S BASCOM AVE
Practice Address - Street 2:STE 200
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-7300
Practice Address - Country:US
Practice Address - Phone:408-356-5292
Practice Address - Fax:408-356-5307
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLTRN9552207R00000X
CAA111738207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine