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General NPI Number Information
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NPI Number | 1205469558
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Entity Type | Individual
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Provider Name | AARON TAN SAN JUAN
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Gender | Male
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Dates
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Enumeration Date | 02/14/2020
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Last Update Date | 02/14/2020
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Provider Practice Location Address
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Address Line | 11700 SOUTH ST STE 200
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City | ARTESIA
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State | CA
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Zip | 90701-6619
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Country | US
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Telephone | 562-468-0088
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Fax | 562-683-3047
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Provider Business Mailing Address
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Address Line | 11700 SOUTH ST STE 200
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City | ARTESIA
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State | CA
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Zip | 90701-6619
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Country | US
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Telephone | 562-468-0088
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Fax |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 50443
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License Number State | CA
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