Individual
GLENN TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8700 BEVERLY BLVD, SUITE 8211, WEST HOLLYWOOD, CA 90048-1804
(213) 637-3703
(213) 639-0797
Mailing address
3530 WILSHIRE BLVD, SUITE 350, LOS ANGELES, CA 90010-2328
(213) 637-3703
(213) 639-0797
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
G72131
CA
207LP3000X
Pediatric Anesthesiology Physician
Primary
G72131
CA
Other
Enumeration date
09/19/2005
Last updated
12/17/2021
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