Organization
RICARDO ANTONIO TAN MD INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICARDP ANTONIO TAN M.D. (OWNER)
(310) 709-2693
Entity
Organization
Contact information
Practice address
5219 CEDROS AVE, SHERMAN OAKS, CA 91411-4016
(310) 709-2693
Mailing address
5219 CEDROS AVE, SHERMAN OAKS, CA 91411-4016
(310) 709-2693
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
A52236
CA
Other
Enumeration date
12/31/2014
Last updated
12/31/2014
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