Individual
DR. KENNETH I-CHIEN TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3880 S. BASCOM AVENUE, #208, SAN JOSE, CA 95124-2675
(408) 377-8100
(408) 377-3044
Mailing address
15680 SHANNON HTS, LOS GATOS, CA 95032-5723
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
G60594
CA
Other
Enumeration date
05/27/2006
Last updated
07/08/2007
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