Provider Demographics
NPI:1306532874
Name:TANG, CINDY
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:TANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 S MCPHERRIN AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-2835
Mailing Address - Country:US
Mailing Address - Phone:626-636-7169
Mailing Address - Fax:
Practice Address - Street 1:120 W HELLMAN AVE STE 302
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1209
Practice Address - Country:US
Practice Address - Phone:626-299-2020
Practice Address - Fax:626-263-2168
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-17
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT35493-TLG152W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program