| Teresita E. Tan, M.d. Inc | |
|
244 S Oxford Ave Ste 9 Los Angeles CA 90004-5126 | |
| (213) 382-1770 | |
| (213) 382-1895 |
| Full Name | Teresita E. Tan, M.d. Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 244 S Oxford Ave Ste 9, Los Angeles, California |
| Authorized Official Name and Position | Teresita E. Tan (DOCTOR) |
| Authorized Official Contact | 2133821770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Teresita E. Tan, M.d. Inc 244 S Oxford Ave Ste 9 Los Angeles CA 90004-5126 Ph: (213) 382-1770 | Teresita E. Tan, M.d. Inc 244 S Oxford Ave Ste 9 Los Angeles CA 90004-5126 Ph: (213) 382-1770 |
| NPI Number | 1023282605 |
|---|---|
| Provider Enumeration Date | 04/15/2008 |
| Last Update Date | 04/15/2008 |
| Medicare PECOS PAC ID | 9234309170 |
|---|---|
| Medicare Enrollment ID | O20110831000641 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023282605 | NPI | - | NPPES |
| 00A403760 | Medicaid | CA | |
| 1396835633 | Other | CA | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A40376 (California) | Primary |
| Provider Name | Teresita E Tan |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1396835633 PECOS PAC ID: 7618147570 Enrollment ID: I20110901000073 |
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