Active NPI
Tia Vang
- Internal Medicine Physician
- Fresno, CA
National Provider Identifier
1679078646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A165951
- Practice address
- 2335 E Kashian LN Ste 280
Fresno, CA 93701-2211 - Phone
- (559) 320-1090
- Fax
- (559) 320-0331
- NPI assigned
- Mar 29, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A165951 | CA | Primary |
Addresses
Primary practice location
2335 E Kashian LN Ste 280
Fresno, CA 93701-2211
Mailing address
2625 E Divisadero St
Fresno, CA 93721-1431
Phone (559) 443-2682
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250714001989 | CA | Order and Referring Only - Family Practice | 8628474442 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A165951 | CA | MD | Internal Medicine Physician |
Interoperability endpoints
- tia.vang.1@17661.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667260800000",
"number": "1679078646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 E DIVISADERO ST",
"city": "FRESNO",
"state": "CA",
"postal_code": "937211431",
"telephone_number": "559-443-2682",
"fax_number": "559-443-2681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2335 E KASHIAN LN STE 280",
"city": "FRESNO",
"state": "CA",
"postal_code": "937012211",
"telephone_number": "559-320-1090",
"fax_number": "559-320-0331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANG",
"first_name": "TIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-29",
"last_updated": "2022-11-01",
"certification_date": "2022-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A165951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; 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.