Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MARVIN TIEU DANG, DO
ActiveSports Medicine · SAN CLEMENTE, CA
Registration Details
- NPI Number
- 1720577687
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 7, 2018 (7.9877848292842 yrs)
- Last Updated
- Oct 20, 2025
- Licenses
-
20A23024 (CA)20A23024 (CA)
Practice Information
- Address
-
993 AVENIDA PICO STE 130SAN CLEMENTE, CA, 926733908Browse CA providers · Browse ZIP 92673
- Phone
- 9495570410
- Primary Specialty
-
Sports Medicine
207QS0010X
- Additional Specialty
- Sports Medicine
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.