Jeremy Lee Tang

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT294455 Issued in CA

Practice address

1941 O'Farrell St.
Suite #115
San Mateo, CA 94403

Phone

(650) 343-5678

Fax

(650) 342-2455

NPI assigned

Feb 15, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1518652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653696000000",
    "number": "1700386885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 O'FARRELL ST.",
            "address_2": "SUITE #115",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "94403",
            "telephone_number": "650-343-5678",
            "fax_number": "650-342-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 O'FARRELL ST.",
            "address_2": "SUITE #115",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "94403",
            "telephone_number": "650-343-5678",
            "fax_number": "650-342-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANG",
        "first_name": "JEREMY",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-15",
        "last_updated": "2022-05-28",
        "certification_date": "2022-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT294455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanna Tan
• Xiao F Tan, PHARMD
• Mariko Tanaka
• Kyle Tanedo
• Maria Tanedo
• Tiffany Tang, DDS
• Yao-Lin Tang, D.D.S.
• Tanner Palliative Care, P.C.
• Joseph Tannous, D.C.
• Pragna Tantravahi

• Physical Therapist in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.