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Individual
MARIA NELISA N TAN
Active
Individual
MARIA NELISA N TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A101565
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0089250
—
CA
05
—
LAB18474F
—
CA
05
—
LAB18474G
—
CA
05
—
RHM53955F
—
CA
Enumeration date
10/09/2007
Last updated
11/02/2007
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