Provider Demographics
NPI:1194119891
Name:TANG, WING CHI (DPT)
Entity type:Individual
Prefix:
First Name:WING CHI
Middle Name:
Last Name:TANG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 E COAST HWY
Mailing Address - Street 2:SUITE 206
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-2104
Mailing Address - Country:US
Mailing Address - Phone:949-675-2922
Mailing Address - Fax:
Practice Address - Street 1:2711 E COAST HWY
Practice Address - Street 2:SUITE 206
Practice Address - City:CORONA DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92625-2104
Practice Address - Country:US
Practice Address - Phone:949-675-2922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-20
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA423442251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic