Provider Demographics
NPI:1699909036
Name:TANG, HENRY H (DISPENSING OPTICIAN)
Entity type:Individual
Prefix:MR
First Name:HENRY
Middle Name:H
Last Name:TANG
Suffix:
Gender:M
Credentials:DISPENSING OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:852 CLAY ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-1611
Mailing Address - Country:US
Mailing Address - Phone:415-397-9718
Mailing Address - Fax:415-397-0427
Practice Address - Street 1:852 CLAY ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-1611
Practice Address - Country:US
Practice Address - Phone:415-397-9718
Practice Address - Fax:415-397-0427
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASL1918156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician