Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 101011 | CA |
NPI | 1053766485 |
---|---|
Provider Name | Wei Yu Tang |
First Address | Dublin, CA 94568-4560 |
Second Address | Alameda, CA 94501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2016 |
Last Update Date | 20/07/2021 |