NELLY TAN (NPI# 1871756254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871756254 |
| Entity Type | Individual |
| Full Name | NELLY TAN |
| Credential | MD |
| Practice Address |
757 Westood Plz Rrumc 1621; Mailcode: 743730 Los Angeles CA 90095-8358 |
| Mailing Address |
757 Westwood Plaza Ronald Regan Ucla Medical Center Los Angeles CA 90095 |
| Practice Telephone | 3109579021 |
| Mailing Telephone | 3102678758 |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2020-10-20 |
| NPI Deactivation Date | 02/07/2020 |
| NPI Reactivation Date | 2020-04-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
60018 | AZ | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
A114724 | CA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5777 E Mayo Blvd, Phoenix, AZ 850544502 | 4803421800 |
| Street Address |
757 WESTOOD PLZ RRUMC 1621; MAILCODE: 743730 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90095-8358 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982212155 | Alexandra Gubin | Social Worker | Ucla, 757 Westwood Medical Plaza, Los Angeles, CA 90095 | 2020-07-14 |
| 1952926263 | Georgina Parra | Student in an Organized Health Care Education/Training Program | 10833 Le Conteave, Los Angeles, CA 90095 | 2020-06-11 |
| 1609403575 | Yagmur Muftuoglu | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza, Neurosurgery, Los Angeles, CA 90095 | 2020-03-23 |
| 1619438173 | Brandon Covington Smith | Student in an Organized Health Care Education/Training Program | 727 Westwood Plaza, Dept of Internal Medicine, Los Angeles, CA 90095 | 2019-03-27 |
| 1184184913 | Alexander Daniel Yuen | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza (internal Medicine), Los Angeles, CA 90095 | 2019-03-19 |
| 1790266369 | Dana Saifan | Student in an Organized Health Care Education/Training Program | 1000 Veteran Avenue, Los Angeles, CA 90095 | 2018-08-22 |
| 1427549146 | Courtney Renee' Real | Registered Nurse | 757 Westwood Plz Ste 6236, Los Angeles, CA 90095 | 2018-05-29 |
| 1932605094 | Akash Atul Shah | Student in an Organized Health Care Education/Training Program | Ucla Department of Orthopaedic Surgery, 10833 Le Conte Avenue, 76-116 Chs, Los Angeles, CA 90095 | 2018-04-05 |
| 1316443435 | Dane Jensen Brodke | Orthopaedic Surgery | 757 Westwood Plaza, (orthopaedic Surgery), Los Angeles, CA 90095 | 2018-04-05 |
| 1477058824 | Thomas William Gaither Castellanos | Student in an Organized Health Care Education/Training Program | 757 Westwood Plaza, Urology, Los Angeles, CA 90095 | 2018-03-28 |
| Find all providers in zip 90095 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| 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 Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154933034 | Andrew Lim | Radiology | 200 Medical Plaza Driveway Suite B265, Los Angeles, CA 90095-0001 | 2020-08-20 |
| 1063859874 | John Vidyadhar Hegde | Radiology | Ucla Medical Center Department of Radiation, 200 Ucla Medical Center, Suite B265, Los Angeles, CA 90095-0001 | 2013-06-03 |
| 1134464795 | David Sup Hong | Radiology | 1441 Eastlake Ave # G356, Los Angeles, CA 90089-1019 | 2012-12-07 |
| 1144587742 | Puja Venkat | Radiology | 200 Medical Plz Ste B265, Los Angeles, CA 90095-9416 | 2012-04-19 |
| 1700115698 | John Adam Landsberger | Radiology | 10970 Bellagio Rd, Los Angeles, CA 90077-3203 | 2009-12-23 |
| 1124250642 | All-n-1 Med Corp | Radiology | 4032 Wilshire Blvd, Suite 303, Los Angeles, CA 90010-3405 | 2009-08-17 |
| 1043399397 | Uscc Aquisition Corp | Radiology | Dept 9536, Los Angeles, CA 90084-9536 | 2006-11-06 |
| 1457430399 | Armand Bouzaglou | Radiology | 201 S Alvarado St Ste A, Los Angeles, CA 90057-2320 | 2006-11-02 |
| 1790789287 | Afshin Akhavan Safa | Radiology | 200 Medical Plz, Suite B265, Los Angeles, CA 90095-0001 | 2005-06-13 |
| 1154325652 | David Huang | Radiology | 1225 Wilshire Blvd, Department of Radiation Oncology, Los Angeles, CA 90017-1901 | 2005-06-13 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90095 |
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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.