Healthcare Provider Details

I. General information

NPI: 1316194434
Provider Name (Legal Business Name): LOREEN BARLIN TAN-ESLAO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LOREEN BARLIN TAN M.D.

II. Dates (important events)

Enumeration Date: 08/20/2008
Last Update Date: 05/28/2020
Certification Date: 05/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43112 15TH ST W
LANCASTER CA
93534-6219
US

IV. Provider business mailing address

43112 15TH ST W
LANCASTER CA
93534-6219
US

V. Phone/Fax

Practice location:
  • Phone: 661-726-2266
  • Fax:
Mailing address:
  • Phone: 661-726-2266
  • Fax: 814-827-8419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD434760
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA118220
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: