Individual
HUNG-JUI TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13075 PACIFIC PROMENADE, APT 409, LOS ANGELES, CA 90094-2110
(734) 972-6075
Mailing address
13075 PACIFIC PROMENADE, APT 409, LOS ANGELES, CA 90094-2110
(734) 972-6075
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
201601278
NC
208800000X
Urology Physician
A123731
CA
390200000X
Student in an Organized Health Care Education/Training Program
4301090540
MI
Other
Enumeration date
06/21/2007
Last updated
04/01/2021
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