Imelda Castillo Tan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG000945 Issued in PA

Practice address

3166 Kensington Ave
Philadelphia, PA 19134-2421

Phone

(215) 425-3937

Fax

(215) 739-3661

NPI assigned

Dec 2, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374624000000",
    "number": "1093883340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 ROCKWELL AVENUE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112222",
            "telephone_number": "215-342-0392",
            "fax_number": "215-739-3661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3166 KENSINGTON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191342421",
            "telephone_number": "215-425-3937",
            "fax_number": "215-739-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "IMELDA",
        "middle_name": "CASTILLO",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-02",
        "last_updated": "2013-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allen B Tan, DDS
• Allison Leigh Tan, M.D.
• Anderson Kirk Nigel Go Tan, MD
• Cathy Tan
• Erik X. Tan, MD
• Irene J. Tan, M.D.
• Jayden James Tan
• Jean Cheng Yee Tan, DMD
• Jessica Tan, MD, PHD
• Jonathan M Tan, MD MPH

• Optometrist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.