Doctor Name: | DR. KHEK-TECK TAN |
NPI Number: | 1083753602 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | A62270 |
Business Practice Address: | 8320 Lincoln Blvd Ste 103a Los Angeles, CA - 900452465 |
Business Phone Number: | 3106452455 |
Business Fax Number: | 3104391136 |
Mailing Address: | 8320 Lincoln Blvd Ste 103a, LOS ANGELES |
State: | CA |
Postal Code: | 900452465 |
Phone Number: | 3106452455 |
Fax Number: | 3104391136 |
NPI Enumeration Date: | 02/06/2007 |
NPI Last Update Date: | 03/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A62270 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |