Wong, Dominic Tan

Wong, Dominic Tan is an individual health care provider with primary practice located at 13652 Cantara St Balboa Plaza Bldg, Panorama City CA 91402-5423. He recently has 4 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Nursing Service Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is his primary health care specialty. Wong, Dominic Tan can be contacted via phone (818) 832-7287.

Contact Information

Primary practice address
13652 Cantara St Balboa Plaza Bldg Panorama City CA 91402-5423
Phone: (818) 832-7287
Fax: (818) 250-0061
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X RN 587716 California
Nursing Service Providers / Registered Nurse 163W00000X 587716 California
Nursing Service Providers / Gerontology 163WG0600X NP 15170 California
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 15170 California
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 15170 California

Profile Details

NPI number 1366472649
LBN Legal business name Wong, Dominic Tan
Credentials GNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated Feb 16th, 2023 - about last year

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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