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Individual

DR. BERNARDO O TAN JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9305 W THOMAS RD, SUITE #410, PHOENIX, AZ 85037-3328
(623) 322-8478
(623) 322-8430
Mailing address
9305 W THOMAS RD, SUITE 410, PHOENIX, AZ 85037-3328
(623) 322-8478
(623) 322-8430

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
32141
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
946923-01
AZ
Enumeration date
04/28/2006
Last updated
01/11/2011
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