Individual
NICHOLAS GAN TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
975 SERENO DR, VALLEJO, CA 94589-2441
(909) 633-2881
Mailing address
521 GREENBRIAR CIR, PETALUMA, CA 94954-3528
(909) 633-2881
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
EL6709
CA
Other
Enumeration date
07/22/2014
Last updated
12/06/2021
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