Active NPI
Teresa Tan, OTRIL
- Occupational Therapist
- San Gabriel, CA
National Provider Identifier
1881753077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 438 W Las Tunas Dr
San Gabriel, CA 91776 - Phone
- (626) 570-6587
- Fax
- (626) 457-3257
- NPI assigned
- Dec 6, 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | CA | Primary |
Addresses
Primary practice location
438 W Las Tunas Dr
San Gabriel, CA 91776
Mailing address
1717 N Avenue 45
Los Angeles, CA 90041
Phone (323) 344-3903
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1881753077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 N AVENUE 45",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90041",
"telephone_number": "323-344-3903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "438 W LAS TUNAS DR",
"city": "SAN GABRIEL",
"state": "CA",
"postal_code": "91776",
"telephone_number": "626-570-6587",
"fax_number": "626-457-3257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAN",
"first_name": "TERESA",
"credential": "OTRIL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Gabriel, CA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.