Teresita E. Tan, M.D. Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

A40376 Issued in CA

Legal business name

TERESITA E. TAN, M.D. INC

Practice address

244 S Oxford Ave Ste 9
Los Angeles, CA 90004-5126

Phone

(213) 382-1770

Fax

(213) 382-1895

NPI assigned

Apr 15, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Teresita E. Tan, M.D.NPI 1396835633

Title

Doctor

Phone

(213) 382-1770

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Teresita Egido Tan, MD

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1396835633
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1023282605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 S OXFORD AVE STE 9",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900045126",
            "telephone_number": "213-382-1770",
            "fax_number": "213-382-1895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 S OXFORD AVE STE 9",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900045126",
            "telephone_number": "213-382-1770",
            "fax_number": "213-382-1895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERESITA E. TAN, M.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "TAN",
        "authorized_official_first_name": "TERESITA",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "213-382-1770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A40376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A403760",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1396835633",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Vicktoria Terian, OD
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• Sona Terjanyan, MSN, RN, FNP-BC
• Sepi Termechi, OTR/L
• Farnoush Termeforoosh, MFT

• Primary Care Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.