Catherine Tan, MD | |
1454 E 2nd St, San Bernardino, CA 92408-0118 | |
(909) 382-7146 | |
Not Available |
Full Name | Catherine Tan |
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Gender | Female |
Speciality | Pediatrics |
Location | 1454 E 2nd St, San Bernardino, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1598870248 | NPI | - | NPPES |
00G781370 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | G78137 (California) | Primary |
Entity Name | Faculty Physicians And Surgeons Of Llusm |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1205009917 PECOS PAC ID: 1153227814 Enrollment ID: O20031211000981 |
Mailing Address | Practice Location Address |
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Catherine Tan, MD 1454 E 2nd St, San Bernardino, CA 92408-0118 Ph: (909) 382-7146 | Catherine Tan, MD 1454 E 2nd St, San Bernardino, CA 92408-0118 Ph: (909) 382-7146 |
Dr. Kofi Adade-boafo, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2150 N Waterman Ave, Ste 200, San Bernardino, CA 92404 Phone: 909-887-7951 Fax: 909-883-1634 | |
Dr. Sajad Jawad Khazal, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 250 E Caroline St Ste E, San Bernardino, CA 92408 Phone: 909-651-1910 | |
Dr. Irene Styadi Tsai, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 685 Carnegie Dr, Ste. #230, San Bernardino, CA 92408 Phone: 909-890-0407 | |
Swapna S. Kudtarkar, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 401 E Highland Ave Ste 450a, San Bernardino, CA 92404 Phone: 909-864-4700 Fax: 909-883-0459 | |
Angie Bagheri Cook, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 565 N. Mount Vernon Ave, San Bernardino, CA 92411 Phone: 909-884-9091 | |
Mrs. Amal Shoukry Ibrahim, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 565 N. Mt. Vernon Ave, San Bernardino, CA 92411 Phone: 909-884-9091 Fax: 909-383-7013 | |
Ms. Lanny Nizar, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2101 N Waterman Ave, San Bernardino, CA 92404 Phone: 909-881-4315 Fax: 909-881-4474 |