Individual provider Active NPI

Yen Kim Tang, PHARMD, BCPS

  • Pharmacist
  • Santa Rosa, CA
National Provider Identifier
1821589490
Registry record updated May 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
75610 Issued in CA
Practice address
401 Bicentennial Way
Santa Rosa, CA 95403-2149
Phone
(626) 371-6114
NPI assigned
May 19, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 3156470 CA
Pharmacist 183500000X 75610 CA Primary

Addresses

Primary practice location

401 Bicentennial Way
Santa Rosa, CA 95403-2149

Mailing address

3404 Van Wig Ave
Baldwin Park, CA 91706-5454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
75610CAMDPharmacist
3156470CAMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1526688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526688000000",
    "number": "1821589490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3404 VAN WIG AVE",
            "city": "BALDWIN PARK",
            "state": "CA",
            "postal_code": "917065454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BICENTENNIAL WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032149",
            "telephone_number": "626-371-6114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANG",
        "first_name": "YEN",
        "middle_name": "KIM",
        "name_prefix": "Dr.",
        "credential": "PHARMD, BCPS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-19",
        "last_updated": "2018-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "CA",
            "license": "3156470",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "75610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2018; 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.