Individual provider Active NPI

Mai Tang

  • Registered Dietitian
  • Redondo Beach, CA
National Provider Identifier
1790519791
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
882992 Issued in CA
Practice address
520 N Prospect Ave Ste 103
Redondo Beach, CA 90277-3033
Phone
(310) 376-8816
NPI assigned
Aug 30, 2024
Last updated
Jul 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 882992 CA Primary

Addresses

Primary practice location

520 N Prospect Ave Ste 103
Redondo Beach, CA 90277-3033

Mailing address

520 N Prospect Ave Ste 103
Redondo Beach, CA 90277-3033
Phone (310) 376-8816

Other practice location 1

20911 Earl St Ste 480
Torrance, CA 90503-4355
Phone (310) 793-2565

Other practice location 2

1499 W 1st St
San Pedro, CA 90732-3255
Phone (310) 831-9482

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250411001431 CA Practitioner - Registered Dietitian Or Nutrition Professional 1254855240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians

Practice addresses (Care Compare)

Glendale, CA 91202

1499 W 1St St
San Pedro, CA 90732-3255
Phone (310) 831-9482

20911 Earl St
Suite 220
Torrance, CA 90503-4353
Phone (310) 540-9600

520 N Prospect Ave
Redondo Beach, CA 90277-3033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
882992CAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Institute CurrentSince May 1, 2025 Accepting new patients
Providence Medical Institute Current Accepting new patients

Locations

5100 W Goldleaf Cir
Fl 2
Los Angeles, CA 90056
Phone (323) 293-7171

520 N Prospect Ave
Ste 103
Redondo Beach, CA 90277
Phone (310) 374-9646

21311 Madrona Ave
Ste 101
Torrance, CA 90503
Phone (310) 792-4012

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1724976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1790519791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N PROSPECT AVE STE 103",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773033",
            "telephone_number": "310-376-8816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N PROSPECT AVE STE 103",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902773033",
            "telephone_number": "310-376-8816"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20911 Earl St Ste 480",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905034355",
            "country_code": "US",
            "telephone_number": "310-793-2565",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1499 W 1st St",
            "address_purpose": "LOCATION",
            "city": "San Pedro",
            "state": "CA",
            "postal_code": "907323255",
            "country_code": "US",
            "telephone_number": "310-831-9482",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANG",
        "first_name": "MAI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-30",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "882992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.