Organization Active NPI

Raymond C. Tan, MD a Professional Corporation

  • Radiation Oncology Physician
  • Merced, CA
National Provider Identifier
1699896357
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
A73252 Issued in CA
Legal business name
RAYMOND C. TAN, MD A PROFESSIONAL CORPORATION
Practice address
3850 G St
Merced, CA 95340-8787
Phone
(209) 386-6000
Fax
(209) 386-6055
NPI assigned
Apr 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Raymond Charles Tan, MD
Title
Ceo
Phone
(209) 386-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X A73252 CA Primary

Addresses

Primary practice location

3850 G St
Merced, CA 95340-8787

Mailing address

PO Box 1360
Mountain View, CA 94042-1360
Phone (209) 386-6000

Other identifiers 1

IdentifierTypeStateIssuer
00A732520MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699896357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1360",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940421360",
            "telephone_number": "209-386-6000",
            "fax_number": "650-618-0465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 G ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953408787",
            "telephone_number": "209-386-6000",
            "fax_number": "209-386-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYMOND C. TAN, MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TAN",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-386-6000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "A73252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A732520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.