Most Relevant Information
Provider Data
| NPI Number: | 1003479536 |
| Provider Name: | WISELEY TANG M.A. |
| Entity Type: | Individual |
| Taxonomy Code: | 247200000X |
| Specialty: | Technician, Other |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/19/2019 |
| Last Updated: | 04/19/2019 |
Provider Practice Location
1600 POTRERO GRANDE DR STE 7
ROSEMEAD
CA
917704167
Practice Location Phone/Fax
| Phone: | 6268720868 |
| Fax: | 6265081186 |
Provider Mailing Location
1600 POTRERO GRANDE DR STE 7
ROSEMEAD
CA
917704167
Provider Mailing Phone/Fax
| Phone: | 6268720868 |
| Fax: | 6265081186 |