Provider Demographics
NPI:1790882678
Name:LANG, DAVID J (MD, INC)
Entity Type:Individual
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First Name:DAVID
Middle Name:J
Last Name:LANG
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Gender:M
Credentials:MD, INC
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Mailing Address - Street 1:359 SAN MIGUEL DR
Mailing Address - Street 2:206
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7812
Mailing Address - Country:US
Mailing Address - Phone:949-706-2751
Mailing Address - Fax:949-706-2761
Practice Address - Street 1:359 SAN MIGUEL DR
Practice Address - Street 2:206
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7812
Practice Address - Country:US
Practice Address - Phone:949-706-2751
Practice Address - Fax:949-706-2761
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2009-05-04
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Provider Licenses
StateLicense IDTaxonomies
DCG508782080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G508780Medicaid
CAA51838Medicare UPIN