Individual
DESMOND T.Y. TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9201 BIG HORN BLVD, ELK GROVE, CA 95758-1240
(916) 478-5100
Mailing address
1800 HARRISON ST FL 7, OAKLAND, CA 94612-3466
(510) 625-6262
(510) 625-6226
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
C53075
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001970260
—
PA
Enumeration date
06/09/2006
Last updated
12/14/2021
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