Provider Demographics
NPI:1255168274
Name:TSANG, GARY
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:
Last Name:TSANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7166 E COLUMBUS DR
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-4528
Mailing Address - Country:US
Mailing Address - Phone:657-766-2228
Mailing Address - Fax:
Practice Address - Street 1:7166 E COLUMBUS DR
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-4528
Practice Address - Country:US
Practice Address - Phone:657-766-2228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-14
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician