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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 12 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 1639174063 NPPES
California MEDICAID 00G444430
California Other W1289

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