Provider Demographics
NPI:1801922729
Name:TANG, ROBERT (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:TANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6955 FOOTHILL BLVD
Mailing Address - Street 2:EASTMONT WELLNESS (SUITE 200)
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605
Mailing Address - Country:US
Mailing Address - Phone:510-567-5800
Mailing Address - Fax:
Practice Address - Street 1:6955 FOOTHILL BLVD STE 200
Practice Address - Street 2:EASTMONT WELLNESS-ALAMEDA COUNTY MEDICAL CENTER
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2426
Practice Address - Country:US
Practice Address - Phone:510-567-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG53548207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine