Tan, Mark

Tan, Mark is an individual health care provider with primary practice located at 209 Fair Oaks Ave , South Pasadena CA 91030-1814. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Plastic Surgery, Allopathic & Osteopathic Physicians / Ophthalmic Plastic and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Ophthalmic Plastic and Reconstructive Surgery is his primary health care specialty. Tan, Mark can be contacted via phone (626) 396-2900.

Contact Information

Primary practice address
209 Fair Oaks Ave South Pasadena CA 91030-1814
Phone: (626) 396-2900
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X A94624 California
Allopathic & Osteopathic Physicians / Ophthalmic Plastic and Reconstructive Surgery 207WX0200X A94624 California

Profile Details

NPI number 1578658266
LBN Legal business name Tan, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2006
Last updated Nov 13th, 2020 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578658266 NPPES
California MEDICAID 00A946240

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