Individual
JESSICA ANNE TANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4646 BROCKTON AVE STE 103, RIVERSIDE, CA 92506-0103
(909) 558-2824
Mailing address
11234 ANDERSON ST RM 2586A, LOMA LINDA, CA 92350-1716
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
A199179
CA
207Y00000X
Otolaryngology Physician
D93310
MD
207Y00000X
Otolaryngology Physician
MT213438
PA
207Y00000X
Otolaryngology Physician
U4948
TX
Other
Enumeration date
07/03/2017
Last updated
01/21/2025
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