Individual
SAMANTHA XIAOYING FANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
50 ACACIA AVE, SAN RAFAEL, CA 94901-2230
(415) 457-4440
Mailing address
2315 33RD AVE, SAN FRANCISCO, CA 94116-2202
(415) 676-7778
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA64308
CA
363AS0400X
Surgical Physician Assistant
Primary
PA64308
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/01/2022
Last updated
03/28/2024
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