Tan, Manuel Pavia
Tan, Manuel Pavia is an sole proprietor health care provider with primary practice located at 4351 E Lohman Ave Ste 301, Las Cruces NM 88011-8259. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Tan, Manuel Pavia can be contacted via phone (575) 532-8900.Contact Information
Primary practice address
4351 E Lohman Ave Ste 301
Las Cruces NM 88011-8259
Phone: (575) 532-8900
Fax: (575) 532-8910
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 93164 | New Mexico |
Profile Details
| NPI number | 1396939096 |
|---|---|
| LBN Legal business name | Tan, Manuel Pavia |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 5th, 2007 |
| Last updated | May 7th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396939096 | NPPES |
| New Mexico | MEDICAID | F9028 |
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