Organization
ALFONSO A TAN MD PC
Active
Other names
Alfonso A Tan
Organization subpart
No
Provider details
NPI number
Authorized official
GILDA TAN (MANAGER)
(480) 832-5500
Entity
Organization
Contact information
Practice address
6844 E BROWN RD STE 101, MESA, AZ 85207-3758
(480) 832-5500
Mailing address
6844 E BROWN RD STE 101, MESA, AZ 85207-3758
(480) 832-5500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22583
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z28281
—
AZ
Enumeration date
06/27/2018
Last updated
06/27/2018
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