Healthcare Provider Details

I. General information

NPI: 1861690299
Provider Name (Legal Business Name): BELINDA H TAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 03/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3870 DEL AMO BLVD UNIT 507
TORRANCE CA
90503-2165
US

IV. Provider business mailing address

3870 DEL AMO BLVD UNIT 507
TORRANCE CA
90503-2165
US

V. Phone/Fax

Practice location:
  • Phone: 310-222-6510
  • Fax: 310-222-1847
Mailing address:
  • Phone: 310-222-6510
  • Fax: 310-222-1847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberA100913
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License NumberA100913
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: