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Individual
JEFFREY C TAN
Active
Individual
JEFFREY C TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16847
NV
207Q00000X
Family Medicine Physician
MD60158622
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09962
—
LA
01
—
1770794216
SMA MEDICAID
NV
05
—
2008990
—
WA
01
—
V50547
SMA MEDICARE
NV
Enumeration date
05/25/2007
Last updated
11/19/2024
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