Basic Information
| Provider Information | |||||||||
| NPI: | 1376653584 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TSANG | ||||||||
| FirstName: | MARILYN | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2301 E QUINCY AVE | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937200450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5592981142 | ||||||||
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| Practice Location | |||||||||
| Address1: | 351 E BARSTOW AVE STE 106 | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937106073 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5592274472 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 170300000X | 2005287 | CA | Y | Other Service Providers | Genetic Counselor, MS |
No ID Information.