Individual
JIAYU TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 7TH ST APT 317, OAKLAND, CA 94607-1989
(510) 705-2585
Mailing address
1400 7TH ST APT 317, OAKLAND, CA 94607-1989
(510) 705-2585
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
08/22/2019
Last updated
08/22/2019
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