Individual
JAN KEVIN TAN MAGPANTAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, AGPCNP-BC
Contact information
Practice address
8700 BEVERLY BLVD, WEST HOLLYWOOD, CA 90048-1804
(323) 398-9731
Mailing address
5020 TORRANCE BLVD, TORRANCE, CA 90503-4116
(323) 398-9731
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
95026172
CA
163WC0400X
Case Management Registered Nurse
95026172
CA
363L00000X
Nurse Practitioner
Primary
95026172
CA
Other
Enumeration date
08/23/2023
Last updated
08/23/2023
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