Tan, Victor T
Tan, Victor T is an individual health care provider with primary practice located at 403 E Madison St , South Bend IN 46617-2322. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Tan, Victor T can be contacted via phone (574) 283-1234.Contact Information
Primary practice address
403 E Madison St
South Bend IN 46617-2322
Phone: (574) 283-1234
Fax: (574) 537-2652
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 20041088A | Indiana |
Profile Details
| NPI number | 1689641243 |
|---|---|
| LBN Legal business name | Tan, Victor T |
| Credentials | PSY.D HSPP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 2nd, 2006 |
| Last updated | Oct 14th, 2010 - about 14 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 | 1689641243 | NPPES |
| Indiana | MEDICAID | 200200740A |
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