Individual
COLLEEN TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 W 30TH ST, LOS ANGELES, CA 90007-3320
(213) 284-3200
Mailing address
400 W 30TH ST, LOS ANGELES, CA 90007-3320
(213) 284-3200
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
03/06/2017
Last updated
06/16/2023
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