| Debra Linda Tang, MD | |
|
483 N Aviation Blvd Bldg 210, El Segundo, CA 90245-2808 | |
| (310) 653-6679 | |
| (310) 653-6453 |
| Full Name | Debra Linda Tang |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 483 N Aviation Blvd Bldg 210, El Segundo, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629142518 | NPI | - | NPPES |
| 00A701790 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | A70179 (California) | Primary |
| Entity Name | Southern California Permanente Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 |
| Entity Name | Northeast Valley Health Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629079009 PECOS PAC ID: 3173517323 Enrollment ID: O20040412001067 |
| Mailing Address | Practice Location Address |
|---|---|
| Debra Linda Tang, MD 483 N Aviation Blvd Bldg 210, El Segundo, CA 90245-2808 Ph: (310) 653-6679 | Debra Linda Tang, MD 483 N Aviation Blvd Bldg 210, El Segundo, CA 90245-2808 Ph: (310) 653-6679 |
Krista Grimm, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 483 N Aviation Blvd Bldg 210, 61 Mds/sgoc, El Segundo, CA 90245 Phone: 310-653-2873 | |
Dr. Syed G Mohiuddin, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 483 N Aviation Blvd, El Segundo, CA 90245 Phone: 310-653-2873 | |
Dr. Elena Del Refugio Ruiz-rios, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 740 S Allied Way Ste D, El Segundo, CA 90245 Phone: 310-500-2045 | |
Dr. Stephanie Mae Lampke, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 483 N Aviation Blvd, El Segundo, CA 90245 Phone: 310-653-2873 | |
Dr. Leonard S Sender, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2040 E Mariposa Ave, El Segundo, CA 90245 Phone: 213-266-5600 | |
Dr. Richard Alan Brucker, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2110 E El Segundo Blvd Ste 210, El Segundo, CA 90245 Phone: 310-784-8704 Fax: 310-893-0430 |