Individual provider Active NPI

William Tan

  • Anesthesiology Physician
  • West Hollywood, CA
National Provider Identifier
1609379387
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
153997 Issued in CA
Practice address
8700 Beverly Blvd Ste 4209
West Hollywood, CA 90048-1804
Phone
(310) 423-3277
NPI assigned
Mar 8, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 153997 CA Primary

Addresses

Primary practice location

8700 Beverly Blvd Ste 4209
West Hollywood, CA 90048-1804

Mailing address

8700 Beverly Blvd Ste 4209
West Hollywood, CA 90048-1804

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200724001403 CA Practitioner - Anesthesiology 4385068279 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Cincinnati College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Anesthesia Associates PCGroup PAC ID 4385070549, 24 clinicians
South Bay Anesthesia Medical Group IncGroup PAC ID 6406899707, 31 clinicians

Practice addresses (Care Compare)

1300 W 7TH St
San Pedro, CA 90732-3505
Phone (310) 832-3311

4101 Torrance Blvd
Torrance, CA 90503-4607
Phone (310) 540-7676

Hospital & facility affiliations

  • Providence Little Company of Mary Med Ctr Torrance Hospital, Torrance, CA, CCN 050353
  • Providence Little Co of Mary Med Ctr San Pedro Hospital, San Pedro, CA, CCN 050078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
153997CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Anesthesia Associates PC Anesthesiology CurrentSince Jun 15, 2021 Accepting new patients
South Bay Anesthesia Medical Group Inc. Anesthesiology CurrentSince Jul 22, 2020 Accepting new patients

Locations

1300 W 7th St
San Pedro, CA 90732
Phone (310) 514-5350

4101 Torrance Blvd
Torrance, CA 90503
Phone (310) 540-7676

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1609379387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLVD STE 4209",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900481804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLVD STE 4209",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900481804",
            "telephone_number": "310-423-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-08",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "153997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

Verify at the official NPI Registry.