Provider Demographics
NPI:1942785670
Name:TANG, STELLA SHIANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:STELLA
Middle Name:SHIANN
Last Name:TANG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 N SHASTA ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-3432
Mailing Address - Country:US
Mailing Address - Phone:714-801-1170
Mailing Address - Fax:
Practice Address - Street 1:4175 E LA PALMA AVE STE 240
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-1842
Practice Address - Country:US
Practice Address - Phone:714-279-6208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-28
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79274183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist