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Antonio A. Tan, Md, Professional Corporation
Clinic/Center in Moreno Valley, California
NPI 1003870676

Antonio A. Tan, Md, Professional Corporation is a Clinic/Center based in Moreno Valley, CA. Antonio A. Tan, Md, Professional Corporation practices in Moreno Valley, CA. The NPI Number for Antonio A. Tan, Md, Professional Corporation is 1003870676 and holds a License No. A45416 (California).

The current practice location address for Antonio A. Tan, Md, Professional Corporation is 12980 Frederick St, Moreno Valley, CA and can be reached out via phone at 951-485-2744 and via fax at 951-485-2749.

Location: 12980 Frederick St, Moreno Valley, CA, 92553-5263
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1003870676
Provider Name
Antonio A. Tan, Md, Professional Corporation
Credential
Provider Entity Type
Organization
Address
12980 Frederick St, Moreno Valley, CA, 92553-5263
Phone Number
951-485-2744
Fax Number
951-485-2749
Provider Enumeration Date
04/12/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00A454161 05 CA
institution
Provider Business Practice Location Address Details
Address
12980 Frederick St
City
Moreno Valley
State
California
Zip
92553-5263
Phone Number
951-485-2744
Fax Number
951-485-2749
person
Provider Business Mailing Address Details
Address
12980 Frederick St
City
Moreno Valley
State
California
Zip
92553-5263
Phone Number
951-485-2744
Fax Number
951-485-2749
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
A45416 (California)
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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