Active NPI
Kaihoo Tang, PA-C
- Medical Physician Assistant
- McClellan, CA
National Provider Identifier
1235368788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 19578
- Practice address
- 5507 Dudley Blvd
McClellan, CA 95652-1015 - Phone
- (707) 816-5884
- NPI assigned
- Jul 6, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 19578 | CA | Primary |
Addresses
Primary practice location
5507 Dudley Blvd
McClellan, CA 95652-1015
Mailing address
15765 Camino Codorniz
San Diego, CA 92127-5823
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Imperial Valley Family Care Medical Group, Apc | Current | Accepting new patients | |
| Access Healthcare LLC | Past | Accepting new patients |
Locations
125 S 5th St
Brawley, CA 92227
Phone (760) 344-8100
516 W Aten Rd
Ste 2
Imperial, CA 92251
Phone (760) 355-7730
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- NPI 1730431875
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472428800000",
"number": "1235368788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15765 CAMINO CODORNIZ",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921275823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5507 DUDLEY BLVD",
"city": "MCCLELLAN",
"state": "CA",
"postal_code": "956521015",
"telephone_number": "707-816-5884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANG",
"first_name": "KAIHOO",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-06",
"last_updated": "2016-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "19578",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McClellan, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.