Individual
DEREK TANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1628 S CONLON AVE, WEST COVINA, CA 91790-4426
(626) 373-4532
Mailing address
1628 S CONLON AVE, WEST COVINA, CA 91790-4426
(626) 373-4532
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
F4846156
CA
Other
Enumeration date
10/20/2021
Last updated
10/20/2021
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