Provider Demographics
NPI:1982660502
Name:TANG, NHIEP (MD)
Entity Type:Individual
Prefix:MR
First Name:NHIEP
Middle Name:
Last Name:TANG
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 1:1155 W CENTRAL AVE
Mailing Address - Street 2:STE 108
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92707
Mailing Address - Country:US
Mailing Address - Phone:714-241-8162
Mailing Address - Fax:714-241-8163
Practice Address - Street 1:1155 W CENTRAL AVE
Practice Address - Street 2:STE 108
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92707
Practice Address - Country:US
Practice Address - Phone:714-241-8162
Practice Address - Fax:714-241-8163
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-22
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA37133208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A371330Medicaid
CA00A371330Medicaid
A84973Medicare UPIN