Provider Demographics
NPI:1255405270
Name:TANG, REN
Entity type:Individual
Prefix:MR
First Name:REN
Middle Name:
Last Name:TANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:AARON
Other - Middle Name:
Other - Last Name:TANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:404 TOYAMA DRIVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94089-2106
Mailing Address - Country:US
Mailing Address - Phone:408-962-0414
Mailing Address - Fax:408-962-0416
Practice Address - Street 1:93 NORTH 14TH STREET
Practice Address - Street 2:#2
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-6200
Practice Address - Country:US
Practice Address - Phone:408-207-5953
Practice Address - Fax:408-962-0416
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2009-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA6045237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHA0060450Medicaid