Daniel W Lopez Tan (NPI# 1932156205, PAC ID# 3577457464) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1932156205 |
| PAC ID by PECOS | 3577457464 |
| Professional Enrollment ID | I20050621000804 |
| Full Name | Daniel W Lopez Tan |
| Organization Legal Name | TOSA MEDICAL GROUP LLC |
| Address |
830 N 109th St Suite 1 Wauwatosa WI 53226-3754 |
| Phone Number | 4147771811 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1990 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | HOSPICE/PALLIATIVE CARE |
| Group Practice PAC ID | 3678621786 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 520008 | WAUKESHA MEMORIAL HOSPITAL |
| 520076 | BEAVER DAM COMMUNITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 830 N 109th St, Suite 1, Wauwatosa, WI 53226-3754 | 4147771811 | TOSA MEDICAL GROUP LLC |
| Organization Legal Name | TOSA MEDICAL GROUP LLC |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Juliana Rose Budd | Nurse Practitioner | Tosa Medical Group LLC | 830 N 109th St, Suite 1, Wauwatosa, WI 53226-3754 |
| Shannon N Walowski | Nurse Practitioner | Tosa Medical Group LLC | 830 N 109th St, Suite 1, Wauwatosa, WI 53226-3754 |
| Bernadette Beaumont | Nurse Practitioner | Tosa Medical Group LLC | 830 N 109th St, Suite 1, Wauwatosa, WI 53226-3754 |
| Barbara J Henry | Nurse Practitioner | Tosa Medical Group LLC | 830 N 109th St, Suite 1, Wauwatosa, WI 53226-3754 |
| Anilkumar Doniparthi | Internal Medicine | Tosa Medical Group LLC | 830 N 109th St, Suite 1, Wauwatosa, WI 53226-3754 |
| Street Address |
830 N 109TH ST SUITE 1 |
| City | WAUWATOSA |
| State | WI |
| Zip | 53226-3754 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Juliana Rose Budd | Nurse Practitioner | Tosa Medical Group LLC | 830 N 109th St, Suite 1, Wauwatosa, WI 53226-3754 |
| Shannon N Walowski | Nurse Practitioner | Tosa Medical Group LLC | 830 N 109th St, Suite 1, Wauwatosa, WI 53226-3754 |
| Bernadette Beaumont | Nurse Practitioner | Tosa Medical Group LLC | 830 N 109th St, Suite 1, Wauwatosa, WI 53226-3754 |
| Barbara J Henry | Nurse Practitioner | Tosa Medical Group LLC | 830 N 109th St, Suite 1, Wauwatosa, WI 53226-3754 |
| Anilkumar Doniparthi | Internal Medicine | Tosa Medical Group LLC | 830 N 109th St, Suite 1, Wauwatosa, WI 53226-3754 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bernadette A Demuri | Psychiatry | Associated Mental Health Consultants Inc | 2600 N Mayfair, Suite 305, Wauwatosa, WI 53226-1303 |
| Kristi L Reynolds | Clinical Social Worker | County of Walworth | 2600 N Mayfair Rd, Suite 305, Wauwatosa, WI 53226-1303 |
| Mariellen Fischer | Psychologist, Clinical | Associated Mental Health Consultants Inc | 2600 N Mayfair, Suite 305, Wauwatosa, WI 53226-1303 |
| Sarah J Ford | Clinical Social Worker | Associated Mental Health Consultants Inc | 2600 N Mayfair, Suite 305, Wauwatosa, WI 53226-1303 |
| Nicole E Heinrich | Clinical Social Worker | County of Walworth | 2600 N Mayfair Rd, Suite 305, Wauwatosa, WI 53226-1303 |
| Ilya Melina Ray | Nurse Practitioner | County of Walworth | 2600 N Mayfair Rd, Suite 305, Wauwatosa, WI 53226-1303 |
| Jennifer K Cicero | Clinical Social Worker | Associated Mental Health Consultants Inc | 2600 N Mayfair, Suite 305, Wauwatosa, WI 53226-1303 |
| Barbara J Reinke | Psychologist, Clinical | Associated Mental Health Consultants Inc | 2600 N Mayfair, Suite 305, Wauwatosa, WI 53226-1303 |
| Mark O Pease | Nurse Practitioner | County of Walworth | 2600 N Mayfair Rd, Suite 305, Wauwatosa, WI 53226-1303 |
| Laura C Liguori | Psychologist, Clinical | Associated Mental Health Consultants Inc | 2600 N Mayfair, Suite 305, Wauwatosa, WI 53226-1303 |
| Find all physicians in zip 53226 | |||
| City | WAUWATOSA |
| Zip Code | 53226 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | WAUWATOSA + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Daniel W Lopez Tan.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.