Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | A66984 | CA |
NPI | 1003994609 |
---|---|
Provider Name | Susan S. Tang |
First Address | Oakland, CA 94612-3466 |
Second Address | San Francisco, CA 94115-3357 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 06/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A669840 | (05) | CA |
H03576 | (02) |