Organization
BENITA B TAN MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENITA B TAN MD (PRESIDENT)
(510) 266-0077
Entity
Organization
Contact information
Practice address
19682 HESPERIAN BLVD, SUITE 202, HAYWARD, CA 94541-4752
(510) 266-0077
(510) 266-0016
Mailing address
2806 MONTAIR PLACE, UNION CITY, CA 94587
(510) 266-0077
(510) 266-0016
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A53599
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A535990
—
CA
Enumeration date
10/25/2006
Last updated
11/12/2007
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