Teresita Egido Tan, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A40376 Issued in CA

Practice address

244 S Oxford Ave
#9
Los Angeles, CA 90004

Phone

(213) 382-1770

Fax

(213) 382-1895

NPI assigned

Oct 16, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Teresita E. Tan, M.D. Inc

  • Primary Care Clinic/Center
  • Los Angeles, CA
  • NPI 1023282605
  Medicare reassignment NPD Authorized official
• Hoag Memorial Hospital Presbyterian

  • General Acute Care Hospital
  • Newport Beach, CA
  • NPI 1518951300
  NPD (past)

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292889600000",
    "number": "1396835633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 S OXFORD AVE",
            "address_2": "#9",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900045173",
            "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",
            "address_2": "#9",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90004",
            "telephone_number": "213-382-1770",
            "fax_number": "213-382-1895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "TERESITA",
        "middle_name": "EGIDO",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2010-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A40376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A403760",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Z Tan, PH.D.
• Ricardo Antonio Tan, MD
• Salinas Tan, LCSW 80386
• Shirley Tan, MD
• Steven Tan, MD
• Tiffany Molina Tan
• Wanting Tan, PMHNP
• Winnie Tan, D.D.S.
• Winright Dominic Tan, OT
• Yi Wei Tan

• General Practice Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.