Individual
JEFFREY C TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2845 SIENA HEIGHTS DR, HENDERSON, NV 89052-4153
(702) 617-7227
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16847
NV
207Q00000X
Family Medicine Physician
MD60158622
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09962
—
LA
01
—
1770794216
SMA MEDICAID
NV
05
—
2008990
—
WA
01
—
V50547
SMA MEDICARE
NV
Enumeration date
05/25/2007
Last updated
11/19/2024
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