KENNETH TAN TAN (NPI# 1306008834) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306008834 |
| Entity Type | Individual |
| Full Name | KENNETH TAN TAN |
| Credential | M.D. |
| Practice Address |
5820 Oberlin Dr Ste. 205 San Diego CA 92121-3742 |
| Practice Telephone | 8775708362 |
| Practice Fax Number | 8775708362 |
| Mailing Telephone | 8775708362 |
| Mailing Fax Number | 8775708362 |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2017-01-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
M-2019 | GU | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
J6262 | TX | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780631788 | Kenneth I-chien Tan | Pediatrics | 3880 S. Bascom Avenue, #208, San Jose, CA 95124-2675 | 2006-05-27 |
| 1699039594 | Kenneth Shu-wen Tan | Family Medicine | 3217 S Providence Rd, Columbia, MO 65203-3639 | 2012-06-26 |
| 1396821815 | Kenneth C. Tan | Internal Medicine | 7520 Arroyo Cir, Gilroy, CA 95020-7303 | 2006-10-27 |
| 1013918283 | Kenneth Tan | Family Medicine | 4300 Rose Dr, Yorba Linda, CA 92886-2026 | 2005-08-09 |
| Street Address |
5820 OBERLIN DR STE. 205 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92121-3742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578548822 | Daniel Paul Saurborn | Radiology | 5820 Oberlin Dr, Suite 205, San Diego, CA 92121-3742 | 2005-12-09 |
| 1811370232 | Ralph Jamison Thomas | Dentist | 5820 Oberlin Dr, Suite 109, San Diego, CA 92121-3742 | 2015-07-02 |
| 1528347176 | Ici 24 7 PC | Radiology | 5820 Oberlin Dr, Suite 205, San Diego, CA 92121-3742 | 2011-08-15 |
| 1639343999 | Conn Chiropractic Inc. | Chiropractor | 5820 Oberlin Dr, Suite 204, San Diego, CA 92121-3742 | 2008-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225644917 | Anna Hand | Physical Therapist | 5945 Pacific Center Blvd Bldg #510, San Diego, CA 92121 | 2020-09-18 |
| 1972138030 | Lamarr Joyner | Licensed Vocational Nurse | 5930 Conerstone Court West, Suite 300, San Diego, CA 92121 | 2020-03-10 |
| 1396383212 | La Jolla Professional Plastic Surgery | Plastic Surgery | 4510 Executive Dr. Suite 105, San Diego, CA 92121 | 2019-12-11 |
| 1841852472 | Unmanned Systems Operations Group | Air Carrier | 4655 Executive Dr., Suite 700, San Diego, CA 92121 | 2019-07-03 |
| 1861051922 | Grace Getchell | Behavior Technician | 3978 Sorrento Valley Blvd. #100, San Diego, CA 92121 | 2019-06-11 |
| 1720643299 | Megan Jean Bathen | Behavior Technician | Cortica Behavioral Inc., 7090 Miratech Dr., San Diego, CA 92121 | 2019-05-09 |
| 1346804366 | Daniel Melita | Massage Therapist | 11689 Sorrento Valley Rd Ste Q, San Diego, CA 92121 | 2019-04-25 |
| 1831674464 | Stepahnie Becerra | Behavior Technician | 3978 Sorrento Valley Blvd Suite 100, San Diego, CA 92121 | 2018-09-28 |
| 1265915466 | Ailyn Martinez | Behavior Technician | 3978 Sorrento Valley Bldv, 100, San Diego, CA 92121 | 2018-09-13 |
| 1790265163 | Genben Lifesciences Corporation | Public Health or Welfare | 6370 Lusk Blvd Ste F205, San Diego, CA 92121 | 2018-08-15 |
| Find all providers in zip 92121 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790208155 | St. Jude Radiology Medical Group, Inc. | Radiology | 8070 Entrada De Luz E, San Diego, CA 92127-2561 | 2017-07-18 |
| 1225586423 | Regional Diagnostic Imaging | Radiology | 3731 Torrey View Ct, San Diego, CA 92130-2623 | 2016-09-15 |
| 1093127680 | William James Tom | Radiology | 200 West Arbor Drive, Mc 0834, San Diego, CA 92103-0834 | 2014-05-30 |
| 1649697947 | Ashley Caitlin Altman | Radiology | Uc San Diego Health, 200 West Arbor Drive, Mc 8829, San Diego, CA 92103 | 2014-03-25 |
| 1477811693 | Michele Christina Mcgahan | Radiology | 8745 Aero Drive #200, San Diego, CA 92193-3540 | 2012-04-25 |
| 1447557996 | Luke R Scalcione | Radiology | 7540 Charmant Dr, Apt 1216, San Diego, CA 92122-5044 | 2011-02-18 |
| 1144537606 | Jasmine Jamin Koo | Radiology | 5330 Carroll Canyon Rd Ste 140, San Diego, CA 92121-3758 | 2010-09-04 |
| 1265743595 | David R Wallace Jr. | Radiology | 200 W Arbor Dr # Mc0834, Department of Radiology, San Diego, CA 92102-0834 | 2010-07-01 |
| 1881837748 | John Joseph Krol | Radiology | 11125 Red Cedar Dr, San Diego, CA 92131-1309 | 2009-04-08 |
| 1700022712 | Thomas N. Folan | Radiology | 425 W Beech St Unit 1707, San Diego, CA 92101-2965 | 2008-12-22 |
| Find all providers in SAN DIEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.