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Organization
TIENG TAN, O.D. INC
Active
Organization
TIENG TAN, O.D. INC
Active
Other names
ICU Optometry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIENG MENG TAN O.D. (PRESIDENT)
(626) 458-5393
Entity
Organization
Contact information
Practice address
220 W VALLEY BLVD, SUITE 202, SAN GABRIEL, CA 91776-3738
(626) 458-5393
Mailing address
220 W VALLEY BLVD, SUITE 202, SAN GABRIEL, CA 91776-3738
(626) 458-5393
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT 13131 TPA
CA
Other
Enumeration date
01/11/2007
Last updated
07/01/2014
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