Dr Kenneth I-chien Tan, MD - Medicare Pediatrics in San Jose, CA

Dr Kenneth I-chien Tan, MD is a medicare enrolled "Pediatrics - Neonatal-perinatal Medicine" physician in San Jose, California. His current practice location is 3880 S. Bascom Avenue, #208, San Jose, California. You can reach out to his office (for appointments etc.) via phone at (408) 377-8100.

Dr Kenneth I-chien Tan is licensed to practice in California (license number G60594) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1780631788.

Contact Information

Dr Kenneth I-chien Tan, MD
3880 S. Bascom Avenue, #208,
San Jose, CA 95124-2675
(408) 377-8100
(408) 377-3044

Map and Direction




Physician's Profile

Full NameDr Kenneth I-chien Tan
GenderMale
SpecialityPediatrics - Neonatal-perinatal Medicine
Location3880 S. Bascom Avenue, San Jose, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1780631788
  • Provider Enumeration Date: 05/27/2006
  • Last Update Date: 07/08/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 6800069048
  • Enrollment ID: I20111102000873

Medical Identifiers

Medical identifiers for Dr Kenneth I-chien Tan such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1780631788NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2080N0001XPediatrics - Neonatal-perinatal Medicine G60594 (California)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kenneth I-chien Tan is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Kenneth I-chien Tan, MD
15680 Shannon Hts,
Los Gatos, CA 95032-5723

Ph: () -
Dr Kenneth I-chien Tan, MD
3880 S. Bascom Avenue, #208,
San Jose, CA 95124-2675

Ph: (408) 377-8100

Reviews and Comments


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