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Organization

ANNIE FANG,M.D.,INCORPORATED

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANNIE J. FANG M.D. (PRESIDENT)
(406) 356-3178
Entity
Organization

Contact information

Practice address
700 W PARR AVE, SUITE A, LOS GATOS, CA 95032-1442
(408) 356-3178
Mailing address
700 W PARR AVE, SUITE A, LOS GATOS, CA 95032-1442
(408) 356-3178

Taxonomy

Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
A75496
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A75496
STATEMEDICAL LICENSE
CA
Enumeration date
07/11/2006
Last updated
08/22/2020
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