Active NPI
Carmela Chua Tan, P.A.-C.
- Physician Assistant
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA18675
- Practice address
- 200 W Arbor Dr
San Diego, CA 92103-9000 - Phone
- (800) 926-8273
- Fax
- (888) 539-8781
- NPI assigned
- Nov 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA18675 | CA | Primary |
Addresses
Primary practice location
200 W Arbor Dr
San Diego, CA 92103-9000
Mailing address
File 57326
Los Angeles, CA 90074-0001
Other practice location 1
10666 N Torrey Pines Rd
LA Jolla, CA 92037-1027
Phone (858) 554-8984
Other practice location 2
9300 Campus Point Dr
LA Jolla, CA 92037-1300
Phone (800) 926-8273
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A078 | Other | CHAMPUS | |
| 0PA186750 | Other | BLUE SHIELD OF CA | |
| PA18675 | Medicaid | CA |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
200 W Arbor Dr
San Diego, CA 92103-9000
Phone (858) 657-7000
447 N El Camino Real
Encinitas, CA 92024-1302
Phone (858) 657-7000
6655 Alvarado Rd
San Diego, CA 92120-5208
Phone (800) 926-8273
9300 Campus Point Dr
La Jolla, CA 92037-1300
Phone (800) 926-8273
9350 Campus Point Dr
La Jolla, CA 92037-1300
Phone (800) 926-8273
Hospital & facility affiliations
- UC San Diego Health Hillcrest - Hillcrest Med Ctr
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18675 | CA | MD | Sports Physician Chiropractor |
| PA18675 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the University of California | Current | Accepting new patients | |
| Scripps Health | Current | Accepting new patients | |
| Scripps Clinic Medical Group, Inc | Past | Accepting new patients | |
| Scripps Clinic Medical Group | Past | Accepting new patients | |
| Regents of the University of California Ucsd Head and Neck Surgery | Past | Accepting new patients |
Locations
9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123
9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000
10666 N Torrey Pines Rd
La Jolla, CA 92037
Phone (858) 554-2626
9350 Campus Point Dr
La Jolla, CA 92037
Phone (858) 657-0583
File 57326
Los Angeles, CA 90074
6655 Alvarado Rd
San Diego, CA 92120
Phone (619) 229-3130
6645 Alvarado Rd
San Diego, CA 92120
Phone (619) 229-3172
200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754
9730 Summers Ridge Rd
#100
San Diego, CA 92121
Phone (858) 549-7400
Interoperability endpoints
- ctan10807@scrippshlth.medalliesdirect.net
Organizations & group practices 5
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.
-
- Diagnostic Radiology Physician
- San Diego, CA
- NPI 1558463927
-
- General Acute Care Hospital
- San Diego, CA
- NPI 1487928891
-
- Otolaryngology Physician
- San Diego, CA
- NPI 1679509962
-
- Multi-Specialty Clinic/Center
- San Diego, CA
- NPI 1124003280
-
- Radiation Oncology Physician
- San Diego, CA
- NPI 1073853180
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- San Diego, CA
- NPI 1184722779
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713744000000",
"number": "1811069271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "FILE 57326",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900740001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W ARBOR DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921039000",
"telephone_number": "800-926-8273",
"fax_number": "888-539-8781"
}
],
"practiceLocations": [
{
"address_1": "10666 N Torrey Pines Rd",
"address_purpose": "LOCATION",
"city": "LA Jolla",
"state": "CA",
"postal_code": "920371027",
"country_code": "US",
"telephone_number": "858-554-8984",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9300 Campus Point Dr",
"address_purpose": "LOCATION",
"city": "LA Jolla",
"state": "CA",
"postal_code": "920371300",
"country_code": "US",
"telephone_number": "800-926-8273",
"fax_number": "888-539-8781",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TAN",
"first_name": "CARMELA",
"middle_name": "CHUA",
"credential": "P.A.-C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-14",
"last_updated": "2024-04-22",
"certification_date": "2024-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA18675",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "A078",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF CA",
"identifier": "0PA186750",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PA18675",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.