Vander Laan, Thomas L
Vander Laan, Thomas L is an sole proprietor health care provider with primary practice located at 50 Bellefontaine St Ste 303, Pasadena CA 91105-3132. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Critical Care. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Vander Laan, Thomas L can be contacted via phone (626) 793-4136.Contact Information
Primary practice address
50 Bellefontaine St Ste 303
Pasadena CA 91105-3132
Phone: (626) 793-4136
Fax: (626) 793-8279
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Other Service Providers / Specialist | 174400000X | G44443 | California |
Allopathic & Osteopathic Physicians / Surgery | 208600000X | G44443 | California |
Allopathic & Osteopathic Physicians / Surgical Critical Care | 2086S0102X | G44443 | California |
Profile Details
NPI number | 1639174063 |
---|---|
LBN Legal business name | Vander Laan, Thomas L |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jun 13th, 2005 |
Last updated | Apr 1st, 2013 - about 11 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 | 1639174063 | NPPES |
California | MEDICAID | 00G444430 | |
California | Other | W1289 |
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