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General NPI Number Information
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NPI Number | 1598095788
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Entity Type | Individual
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Provider Name | HAO YANG TAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/11/2010
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Last Update Date | 01/11/2010
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Provider Practice Location Address
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Address Line | 10 CENTER DRIVE ROOM 4C216
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City | BETHESDA
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State | MD
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Zip | 20892-1364
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Country | US
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Telephone | 301-451-2177
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Fax |
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Provider Business Mailing Address
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Address Line | 10409 MONTROSE AVE APT 2
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City | BETHESDA
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State | MD
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Zip | 20814-4119
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Country | US
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Telephone | 301-493-4794
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | D70095
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License Number State | MD
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