Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | G55279 | CA |
NPI | 1235214909 |
---|---|
Provider Name | Dr. Donald Pang |
First Address | Fremont, CA 94536-6705 |
Second Address | Fremont, CA 94536-6705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 10/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G552790 | (05) | CA |
E70056 | (02) | CA |