Individual
YUAN PENG TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9353 VALLEY BLVD STE C, ROSEMEAD, CA 91770-1923
(626) 287-2988
Mailing address
2834 BLOSSOM CT, EL MONTE, CA 91733-2402
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT42079
CA
Other
Enumeration date
10/18/2021
Last updated
10/18/2021
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