Individual
DR. SOON MIN TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
488 E SANTA CLARA ST, SUITE 104, ARCADIA, CA 91006-7231
(626) 357-6808
(626) 357-6290
Mailing address
488 E SANTA CLARA ST, SUITE 104, ARCADIA, CA 91006-7231
(626) 357-6808
(626) 357-6290
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
A66493
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
660003933
MEDICARE RAILROAD
—
01
—
OOA664930
BLUE SHIELD
CA
05
—
OOA664930
—
CA
Enumeration date
10/27/2006
Last updated
12/08/2020
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