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General NPI Number Information
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NPI Number | 1205071677
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Entity Type | Individual
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Provider Name | GEORGE TAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/12/2008
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Last Update Date | 11/28/2023
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Provider Practice Location Address
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Address Line | 5119 CAMINO AL NORTE
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89031-2373
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Country | US
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Telephone | 702-625-8989
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Fax | 702-331-3115
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Provider Business Mailing Address
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Address Line | 5119 CAMINO AL NORTE STE 100
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City | N LAS VEGAS
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State | NV
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Zip | 89031-2373
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Country | US
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Telephone | 702-625-8989
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Fax | 702-331-3115
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A103328
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 20694
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License Number State | NV
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