Individual provider Active NPI

Fanny Yin Tan, PHARMD

  • Pharmacist
  • San Francisco, CA
National Provider Identifier
1487261459
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
82499 Issued in CA
Practice address
300 Montgomery St
San Francisco, CA 94104-1902
Phone
(415) 828-1691
Fax
(415) 788-2017
NPI assigned
Sep 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 82499 CA Primary

Addresses

Primary practice location

300 Montgomery St
San Francisco, CA 94104-1902

Mailing address

300 Montgomery St
San Francisco, CA 94104-1902
Phone (415) 788-2984

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL rxm.02521@store.walgreens.com

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
82499CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1487261459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MONTGOMERY ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941041902",
            "telephone_number": "415-788-2984",
            "fax_number": "415-788-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MONTGOMERY ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941041902",
            "telephone_number": "415-828-1691",
            "fax_number": "415-788-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "FANNY",
        "middle_name": "YIN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "82499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "rxm.02521@store.walgreens.com",
            "affiliation": "N",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "rxm.02521@store.walgreens.com",
            "address_1": "300 Montgomery St",
            "city": "San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "941041902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.