Provider Demographics
NPI:1881704351
Name:TANG, TRUNG (DC)
Entity type:Individual
Prefix:DR
First Name:TRUNG
Middle Name:
Last Name:TANG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2470 BERRYESSA RD STE E
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95133-1309
Mailing Address - Country:US
Mailing Address - Phone:408-258-9100
Mailing Address - Fax:408-258-5300
Practice Address - Street 1:2470 BERRYESSA RD STE E
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95133-1309
Practice Address - Country:US
Practice Address - Phone:408-258-9100
Practice Address - Fax:408-258-5300
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 27176111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor