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Individual

MS. BRIANA TAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
400 W MINERAL KING AVE, VISALIA, CA 93291-6237
(559) 624-2213
Mailing address
393 E WALNUT ST FL 3, PHR GROUP PROVIDER ENROLLMENT UNIT, PASADENA, CA 91188-0001
(877) 608-0044
(877) 514-0903

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
57253
CA

Other

Enumeration date
11/18/2019
Last updated
03/11/2022
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