Individual
MR. OLIVER BRYAN TAN NGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
REGISTERED NURSE
Contact information
Practice address
2345 NEW BRIGHTON LN, STOCKTON, CA 95209-4290
(559) 380-6641
(209) 451-2561
Mailing address
1737 PAGOLA AVE, MANTECA, CA 95337-8628
(559) 380-6641
(209) 451-2561
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
735801
CA
163WG0000X
General Practice Registered Nurse
735801
CA
163WH1000X
Hospice Registered Nurse
735801
CA
Other
Enumeration date
06/12/2024
Last updated
06/12/2024
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