Provider Demographics
NPI:1053757195
Name:TANG, VANESSA JOYCE (MD)
Entity type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:JOYCE
Last Name:TANG
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:25500 N NORTERRA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-8200
Mailing Address - Country:US
Mailing Address - Phone:623-277-1130
Mailing Address - Fax:866-837-6575
Practice Address - Street 1:1920 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1511
Practice Address - Country:US
Practice Address - Phone:480-453-5000
Practice Address - Fax:480-345-5266
Is Sole Proprietor?:No
Enumeration Date:2013-05-16
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZR73751207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ192769Medicaid