Provider Demographics
NPI:1215947247
Name:TANG, NATHAN H (MD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:H
Last Name:TANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:414 G ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MARYSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95901-5663
Mailing Address - Country:US
Mailing Address - Phone:530-741-2393
Mailing Address - Fax:530-741-2396
Practice Address - Street 1:414 G ST
Practice Address - Street 2:SUITE 110
Practice Address - City:MARYSVILLE
Practice Address - State:CA
Practice Address - Zip Code:95901-5663
Practice Address - Country:US
Practice Address - Phone:530-741-2393
Practice Address - Fax:530-741-2396
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA55241207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A552410Medicaid
CAG62899Medicare UPIN
CA00A552410Medicare ID - Type Unspecified