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General NPI Number Information
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NPI Number | 1518527845
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Entity Type | Individual
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Provider Name | MATTHEW HONG GIE TAN MD
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Gender | Male
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Dates
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Enumeration Date | 06/18/2019
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 1950 E 17TH ST STE 200
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City | SANTA ANA
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State | CA
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Zip | 92705-6852
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Country | US
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Telephone | 714-495-4050
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Fax | 714-497-1485
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Provider Business Mailing Address
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Address Line | 2601 E CHAPMAN AVE
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City | ORANGE
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State | CA
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Zip | 92869-3206
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Country | US
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Telephone | 714-633-0011
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 036165387
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A182435
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License Number State | CA
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