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:
Health care specialties
| Specialty | Code | License # | 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 6 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 | 1578658266 | NPPES |
| California | MEDICAID | 00A946240 |
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