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Individual

MICHAEL TAI TANG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
424 S 7TH ST, SAN JOSE, CA 95112-3809
(408) 638-1359
Mailing address
424 S 7TH ST, SAN JOSE, CA 95112-3809
(408) 638-1359

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
07/28/2019
Last updated
07/28/2019
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