Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | A98847 | CA |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | D72737 | MD |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 257822 | NY |
NPI | 1114124369 |
---|---|
Provider Name | Dr. Edward Yi-Teh Tang |
First Address | Martinez, CA 94553-3156 |
Second Address | Martinez, CA 94553-3156 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 10/06/2015 |