Provider Demographics
NPI:1366544629
Name:TANG, GEORGE (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:TANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:10 CONGRESS STREET
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105
Mailing Address - Country:US
Mailing Address - Phone:626-795-0282
Mailing Address - Fax:626-792-0682
Practice Address - Street 1:10 CONGRESS ST
Practice Address - Street 2:SUITE 103
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3023
Practice Address - Country:US
Practice Address - Phone:626-795-0282
Practice Address - Fax:626-792-0682
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2010-10-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA78792204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH68746Medicare UPIN