Peter X. Tan Medical Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A69134 Issued in CA

Legal business name

PETER X. TAN MEDICAL CORPORATION

Practice address

1990 Sierra Madre Villa Ave
Pasadena, CA 91107-1235

Phone

(626) 354-9113

Fax

(626) 389-5055

NPI assigned

Jan 17, 2007

Organization subpart

No

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

Authorized official

Name

Peter X. Tan, M.D.NPI 1144228909

Title

President

Phone

(626) 354-9113

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter Xuepeng Tan, M.D.

  • Internal Medicine Physician
  • Arcadia, CA
  • NPI 1144228909
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512604800000",
    "number": "1649322975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 SIERRA MADRE VILLA AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911071235",
            "telephone_number": "626-354-9113",
            "fax_number": "626-389-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 SIERRA MADRE VILLA AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911071235",
            "telephone_number": "626-354-9113",
            "fax_number": "626-389-5055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER X. TAN MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2017-12-07",
        "status": "A",
        "authorized_official_last_name": "TAN",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "X.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-354-9113",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A69134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A691340",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Summer Nerissa Perry, PH.D, MFT
• Coland Person Jr.
• Marisa Peryer
• Peter Huang MFT
• Peter Wei Medical Corporation
• Robin Patricia Petering, B.S.
• Deborah Peters, PHD
• Elinor S. Peters, N.P.
• Steven Peters
• William Peters

• Internal Medicine Physician in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.