# BENITA B TAN MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548344625
- **Authorized official:** DR. BENITA B TAN MD (PRESIDENT)
- **Authorized official phone:** (510) 266-0077

## Contact information

- **Practice address:** 19682 HESPERIAN BLVD, SUITE 202, HAYWARD, CA 94541-4752
- **Practice address phone:** (510) 266-0077
- **Practice address fax:** (510) 266-0016
- **Mailing address:** 2806 MONTAIR PLACE, UNION CITY, CA 94587
- **Mailing address phone:** (510) 266-0077
- **Mailing address fax:** (510) 266-0016

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | A53599 | CA | Yes |

## Other

- **Enumeration date:** 10/25/2006
- **Last updated:** 11/12/2007