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Kim Thu Tang, M.D.

Dermatology in Lake Forest, CA. Individual provider (NPI-1).

NPI number1790746147
StatusActive
Last updated in NPPESOct 6, 2020

Details

NPI
1790746147
Entity type
Individual (NPI-1)
Name
Kim Thu Tang
Credential
M.D.
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 28, 2006
Certification date
Oct 6, 2020
Last updated
Oct 6, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207N00000X DermatologyG78563CAYes

Practice location

23832 Rockfield Blvd Ste 210
Lake Forest, CA 92630-2876

Phone 949-770-8115 · Fax 949-770-2017

Mailing address

23832 Rockfield Blvd Ste 210
Lake Forest, CA 92630-2876

Phone 949-770-8115 · Fax 949-770-2017

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