Provider Demographics
NPI:1184445280
Name:DANG, ANTHONY (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:DANG
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1929 N FAIRVIEW ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706-2205
Mailing Address - Country:US
Mailing Address - Phone:714-251-9271
Mailing Address - Fax:
Practice Address - Street 1:1929 N FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-2205
Practice Address - Country:US
Practice Address - Phone:714-251-9271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA307159225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist