Oliver Bryan Tan Ngan, REGISTERED NURSE

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

735801 Issued in CA

Practice address

2345 New Brighton LN
Stockton, CA 95209-4290

Phone

(559) 380-6641

Fax

(209) 451-2561

NPI assigned

Jun 12, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ielo Care LLC

  • Assisted Living Facility
  • Stockton, CA
  • NPI 1619866373
  NPD Authorized official
• Olexe Transport LLC

  • Non-emergency Medical Transport (VAN)
  • Manteca, CA
  • NPI 1790677060
  NPD

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1396587077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1737 PAGOLA AVE",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953378628",
            "telephone_number": "559-380-6641",
            "fax_number": "209-451-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 NEW BRIGHTON LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952094290",
            "telephone_number": "559-380-6641",
            "fax_number": "209-451-2561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGAN",
        "first_name": "OLIVER BRYAN",
        "middle_name": "TAN",
        "name_prefix": "Mr.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "735801",
            "primary": false
        },
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "CA",
            "license": "735801",
            "primary": false
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "CA",
            "license": "735801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johansen NG, MD
• Timothy NG, O.D.
• Whitney D NG, O.D.
• Mama Ngaima
• Kear Heng Ngam
• Candice Athena Ngo
• James Ngo, D.O.
• Mary Ngo
• Shelly Ngo
• Vincent Trung H Ngo, MD

• Administrator Registered Nurse in Stockton, CA
• Providers in Stockton, CA by specialty
• Administrator Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.