Provider Demographics
NPI:1588744072
Name:LI, TIANHONG (MD,PHD)
Entity type:Individual
Prefix:
First Name:TIANHONG
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:MD,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 X STREET, SUITE 3016
Mailing Address - Street 2:CANCER CENTER, HEMATOLOGY AND ONCOLOGY
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2219
Mailing Address - Country:US
Mailing Address - Phone:916-734-3772
Mailing Address - Fax:916-734-7946
Practice Address - Street 1:2278 45TH STREET
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2229
Practice Address - Country:US
Practice Address - Phone:916-734-5959
Practice Address - Fax:916-703-5265
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC53681207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1588744072OtherMEDI-CAL