Individual
MAYBEL MIN TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
3114 W BEVERLY BLVD, MONTEBELLO, CA 90640-2217
(323) 726-3868
Mailing address
2149 E WARNER RD, STE 102, TEMPE, AZ 85284-3495
(480) 393-0309
(480) 610-6189
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
A126350
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053657684
—
CA
Enumeration date
12/31/2012
Last updated
08/22/2019
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