Individual
MR. EDSEL TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
1131 WILSHIRE BLVD, SUITE 300, SANTA MONICA, CA 90401-2061
(310) 917-2200
(310) 917-2204
Mailing address
1131 WILSHIRE BLVD, SUITE 300, SANTA MONICA, CA 90401-2061
(310) 917-2200
(310) 917-2204
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC 12003
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AC 12003
LICENSE
CA
Enumeration date
11/06/2007
Last updated
10/15/2008
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