Individual
DR. RICARDO ANTONIO TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1950 SAWTELLE BLVD STE 138, LOS ANGELES, CA 90025-7014
(310) 966-9022
(310) 966-9042
Mailing address
5219 CEDROS AVE, SHERMAN OAKS, CA 91411-4016
(310) 709-2693
(661) 266-3766
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
A052236
CA
Other
Enumeration date
07/24/2006
Last updated
03/24/2017
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