Ricardo Antonio Tan MD Inc.

Primary specialty

Allergy & Immunology (Internal Medicine) PhysicianTaxonomy code 207RA0201X

License

A52236 Issued in CA

Legal business name

RICARDO ANTONIO TAN MD INC.

Practice address

5219 Cedros Ave
Sherman Oaks, CA 91411-4016

Phone

(310) 709-2693

NPI assigned

Dec 31, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Ricardp Antonio Tan, M.D.

Title

Owner

Phone

(310) 709-2693

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Ricardo Antonio Tan, MD

  • Allergy Physician
  • Los Angeles, CA
  • NPI 1255353629
  Medicare reassignment
• Katlin Mariah Moody

  • Family Nurse Practitioner
  • Lancaster, CA
  • NPI 1629853858
  NPD (past)

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

{
    "created_epoch": "1419984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419984000000",
    "number": "1881082683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5219 CEDROS AVE",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914114016",
            "telephone_number": "310-709-2693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5219 CEDROS AVE",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914114016",
            "telephone_number": "310-709-2693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICARDO ANTONIO TAN MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-31",
        "last_updated": "2014-12-31",
        "status": "A",
        "authorized_official_last_name": "TAN",
        "authorized_official_first_name": "RICARDP",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-709-2693",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RA0201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "CA",
            "license": "A52236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ilya Reyter, M.D.
• Wissam Rhayem
• Rhodes Care Inc.
• John Edward Rhone, MFCC
• Rhythm & Rise LLC
• Daniel Allen Rice, M.A.
• Jill Auslander Rice, LCSW
• Rachel Rich, M.A.,
• Shelli Lynne Rich
• Richard J. Sarte, DPM, Inc

• Allergy & Immunology (Internal Medicine) Physician in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Allergy & Immunology (Internal Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; 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.