Individual
DR. MARY ANNE TAN LAXA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3951 W STETSON AVE STE A, HEMET, CA 92545-9683
(951) 765-7002
(951) 765-7003
Mailing address
3951 W STETSON AVE STE A, HEMET, CA 92545-9683
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
A76409
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A764090
—
CA
Enumeration date
09/28/2006
Last updated
10/23/2025
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