Individual
CATHERINE TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4305 UNIVERSITY AVE, SAN DIEGO, CA 92105-1645
(619) 501-1235
Mailing address
4305 UNIVERSITY AVE STE 150, SAN DIEGO, CA 92105-1690
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
101790
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2016
Last updated
03/21/2019
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