Luhong Tan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

63915 Issued in CA

Practice address

1661 Hanover Rd Ste 103
City of Industry, CA 91748-5705

Phone

(626) 286-8700

Fax

(626) 286-8650

NPI assigned

Jun 9, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Herald Christian Health CenterGroup PAC ID 0941337117, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: ltan2141669@direct.trinity-health.org
• FHIR API: https://fhir4.healow.com/fhir/r4/FIFJBA

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.

• Herald Christian Health Center

  • Federally Qualified Health Center (FQHC)
  • San Gabriel, CA
  • NPI 1033390273
  Medicare reassignment Care Compare group NPD
• Herald Christian Health Center

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1669907135
  NPD

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1891424370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 AERO JET AVE",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917312801",
            "telephone_number": "626-286-8700",
            "fax_number": "626-286-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 HANOVER RD STE 103",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917485705",
            "telephone_number": "626-286-8700",
            "fax_number": "626-286-8650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1070 N Curtis Rd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837061258",
            "country_code": "US",
            "telephone_number": "208-367-2121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6051 W Emerald St",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837048969",
            "country_code": "US",
            "telephone_number": "208-302-5150",
            "fax_number": "208-302-5155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAN",
        "first_name": "LUHONG",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-09",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2300",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "63915",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "1191213",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Super Care, LLC (Supercare)
• Surgical Anesthesia Medical Associates Inc
• Candelario Tablason
• Bianca Mariah Tamayo
• Evelyn Tan
• Ardini Tandya, DDS
• Olivia Tang
• Valerie Tapia
• Maya Tasevski
• Brienna Taylor

• Physician Assistant in City of Industry, CA
• Providers in City of Industry, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.

Verify at the official NPI Registry.