Basic Information
| Provider Information | |||||||||
| NPI: | 1154421089 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | FRANK QUEI-CHUAN, TANG MD.FAAP.INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | FRANK QUEI-CHUAN, TANG MD.FAAP.INC. | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 40690 CALIFORNIA OAKS RD # A | ||||||||
| Address2: | |||||||||
| City: | MURRIETA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925625857 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9516770098 | ||||||||
| FaxNumber: | 9516772017 | ||||||||
| Practice Location | |||||||||
| Address1: | 40690 CALIFORNIA OAKS RD # A | ||||||||
| Address2: | |||||||||
| City: | MURRIETA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 925625857 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9516770098 | ||||||||
| FaxNumber: | 9516772017 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | TANG | ||||||||
| AuthorizedOfficialFirstName: | FRANK | ||||||||
| AuthorizedOfficialMiddleName: | QUEI-CHUAN | ||||||||
| AuthorizedOfficialTitleorPosition: | FAAP. | ||||||||
| AuthorizedOfficialTelephone: | 9516770098 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | A38063 | CA | X | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics | 208D00000X | A38063 | CA | X | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice |
ID Information
| ID | Type | State | Issuer | Description | 00A380630 | 05 | CA | MEDICAID |