Individual
MS. VIA GERONGA TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
15107 VANOWEN ST, VAN NUYS, CA 91405-4542
(818) 782-6600
Mailing address
17124 INDEX ST, GRANADA HILLS, CA 91344-4131
(818) 687-2516
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
685385
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
95001439
CA
Other
Enumeration date
02/03/2021
Last updated
04/21/2022
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