Individual
DR. GORDON TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12815 HEACOCK ST, MORENO VALLEY, CA 92553-2836
(951) 601-6399
Mailing address
12815 HEACOCK ST, MORENO VALLEY, CA 92553-2836
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A122192
CA
Other
Enumeration date
04/26/2011
Last updated
11/30/2024
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