Kenneth I-Chien Tan, M.D.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

G60594 Issued in CA

Practice address

3880 S. Bascom Avenue
#208
San Jose, CA 95124-2675

Phone

(408) 377-8100

Fax

(408) 377-3044

NPI assigned

May 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780631788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15680 SHANNON HTS",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950325723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 S. BASCOM AVENUE",
            "address_2": "#208",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951242675",
            "telephone_number": "408-377-8100",
            "fax_number": "408-377-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "KENNETH",
        "middle_name": "I-CHIEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CA",
            "license": "G60594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greta C Tan, OTR-L
• Greta T Tan
• Jacqueline Tan, PA-C
• Jiahui Tan, L.AC.
• Kenneth Tan, M.D.
• Leon L Tan, MD
• Li Tan
• Lucas Go Tan, MD
• Nguyen Tan
• Tina O Tan, MD

• Neonatal-Perinatal Medicine Physician in San Jose, CA
• Providers in San Jose, CA by specialty
• Neonatal-Perinatal Medicine Physician in California

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.