Active NPI
Mildred Q Tan
- Medical Technologist
- Chino Hills, CA
National Provider Identifier
1396958492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Technologist
- License
- MTA18571
- Practice address
- 13565 Monte Royale Dr
Chino Hills, CA 91709-1381 - Phone
- (909) 627-1782
- NPI assigned
- May 7, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Technologist | 246QM0706X | MTA18571 | CA | Primary |
Addresses
Primary practice location
13565 Monte Royale Dr
Chino Hills, CA 91709-1381
Mailing address
13565 Monte Royale Dr
Chino Hills, CA 91709-1381
Phone (909) 627-1782
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MTA18571 | CA | MD | Medical Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396958492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13565 MONTE ROYALE DR",
"city": "CHINO HILLS",
"state": "CA",
"postal_code": "917091381",
"telephone_number": "909-627-1782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13565 MONTE ROYALE DR",
"city": "CHINO HILLS",
"state": "CA",
"postal_code": "917091381",
"telephone_number": "909-627-1782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAN",
"first_name": "MILDRED",
"middle_name": "Q",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "246QM0706X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Pathology, Medical Technologist",
"state": "CA",
"license": "MTA18571",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chino Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.