| Mai Tang, | |
|
520 N Prospect Ave Ste 103, Redondo Beach, CA 90277-3033 | |
| (310) 376-8816 | |
| Not Available |
| Full Name | Mai Tang |
|---|---|
| Gender | Female |
| Speciality | Registered Dietitian Or Nutrition Professional |
| Experience | 26 Years |
| Location | 520 N Prospect Ave Ste 103, Redondo Beach, California |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790519791 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 882992 (California) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Providence Medical Institute | 5991609737 | 303 |
| Provider Name | Providence Medical Institute |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1417915760 PECOS PAC ID: 5991609737 Enrollment ID: O20031121000910 |
| Mailing Address | Practice Location Address |
|---|---|
| Mai Tang, 520 N Prospect Ave Ste 103, Redondo Beach, CA 90277-3033 Ph: (310) 376-8816 | Mai Tang, 520 N Prospect Ave Ste 103, Redondo Beach, CA 90277-3033 Ph: (310) 376-8816 |
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