Provider Demographics
NPI:1053363937
Name:TANG, JEANETTE ELAINE (OD)
Entity type:Individual
Prefix:DR
First Name:JEANETTE
Middle Name:ELAINE
Last Name:TANG
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:14726 RAMONA AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-5730
Mailing Address - Country:US
Mailing Address - Phone:626-305-9100
Mailing Address - Fax:626-305-0152
Practice Address - Street 1:11550 INDIAN HILLS RD
Practice Address - Street 2:SUITE 341
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1200
Practice Address - Country:US
Practice Address - Phone:818-365-0606
Practice Address - Fax:818-898-0205
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAOPT 11837TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist