Tan, Maria Nelisa N
Tan, Maria Nelisa N is an individual health care provider with primary practice located at 2450 Sister Mary Columba Dr , Red Bluff CA 96080-4356. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Tan, Maria Nelisa N can be contacted via phone (530) 527-0414.Contact Information
Primary practice address
2450 Sister Mary Columba Dr
Red Bluff CA 96080-4356
Phone: (530) 527-0414
Fax: (530) 528-4423
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | A101565 | California |
Profile Details
| NPI number | 1457549107 |
|---|---|
| LBN Legal business name | Tan, Maria Nelisa N |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 9th, 2007 |
| Last updated | Nov 2nd, 2007 - about 18 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 | 1457549107 | NPPES |
| California | MEDICAID | LAB18474G | |
| California | MEDICAID | GR0089250 | |
| California | MEDICAID | RHM53955F | |
| California | MEDICAID | LAB18474F |
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