Provider Demographics
NPI:1699745489
Name:TANG, HANK K (MD)
Entity type:Individual
Prefix:
First Name:HANK
Middle Name:K
Last Name:TANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 650811
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0811
Mailing Address - Country:US
Mailing Address - Phone:972-715-5000
Mailing Address - Fax:
Practice Address - Street 1:3751 KATELLA AVE
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3113
Practice Address - Country:US
Practice Address - Phone:562-799-3151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC54078207L00000X
WI1376207L00000X
CO40643207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04706030Medicaid
CA00C540780OtherBLUE SHIELD
CA1942504501OtherBLUE CROSS
CA1699745489Medicaid
517918Medicare ID - Type Unspecified
CO04706030Medicaid
H83589Medicare UPIN
CA1942504501OtherBLUE CROSS