Provider Demographics
NPI:1992873723
Name:TSANG, NANG LOK ELLICK (MD)
Entity type:Individual
Prefix:
First Name:NANG LOK ELLICK
Middle Name:
Last Name:TSANG
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 1:3055 26TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-1545
Mailing Address - Country:US
Mailing Address - Phone:415-648-5900
Mailing Address - Fax:650-491-7735
Practice Address - Street 1:3085 24TH ST
Practice Address - Street 2:STE 203
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4153
Practice Address - Country:US
Practice Address - Phone:415-648-5900
Practice Address - Fax:650-491-7735
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA A053928207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A539280Medicaid
CA00A539282Medicare ID - Type Unspecified3555 ARMY ST., S.F.
CA00A539280Medicaid
CA00A539280Medicare ID - Type Unspecified1800 SULLIVAN AVE, STE104
CA00A539283Medicare ID - Type Unspecified1900 SULLIVAN AVE