Individual
ALLEN TANG THACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1196 3RD AVE, CHULA VISTA, CA 91911-3131
(619) 427-4661
Mailing address
1196 THIRD AVE, CHULA VISTA, CA 91911-3131
(619) 427-4661
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
CA
Other
Enumeration date
04/10/2024
Last updated
04/25/2024
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