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NPI Code Detail

MEDICARE: YOLANDA TAN

MEDICARE: YOLANDA TAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11604763872OTHERNVDL

General Provider Information

NPI Number : 1871144006
Entity Type Code : Individual
Provider Name (Legal Business Name) : YOLANDA TAN
Provider Business Mailing Address
First Line : 1500 E TROPICANA AVE STE 158
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-6516
Country : US
Telephone Number : 702-450-1704
Fax Number : 702-650-0201
Provider Business Practice Location Address
First Line : 1500 E TROPICANA AVE STE 158
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-6516
Country : US
Telephone Number : 702-450-1704
Fax Number : 702-650-0201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2019
Last Update Date : 09/29/2019

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Directions to “ YOLANDA TAN ” Practice Location

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