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Individual
YONG TAN
Active
Individual
YONG TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A055855
CA
207Q00000X
Family Medicine Physician
Primary
A55855
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GR0066310
MEDI-CAL GROUP
CA
01
—
W13536A
MEDICARE GROUP
CA
01
—
W13536B
MEDIARE GROUP #
CA
01
—
W13536C
MEDICARE GROUP #
CA
01
—
W13536D
MEDICARE GROUP #
CA
Enumeration date
01/03/2007
Last updated
11/08/2012
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