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General NPI Number Information
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NPI Number | 1932166238
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Entity Type | Organization
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Legal Business Name | JOSHUA CH TAN MD INC
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 12/31/2014
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Provider Practice Location Address
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Address Line | 550 S BERETANIA ST STE # 608
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City | HONOLULU
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State | HI
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Zip | 96813-2414
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Country | US
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Telephone | 808-949-8988
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Fax | 808-538-1920
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Provider Business Mailing Address
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Address Line | 550 S BERETANIA ST STE # 608
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City | HONOLULU
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State | HI
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Zip | 96813-2496
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Country | US
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Telephone | 808-949-8988
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Fax | 808-538-1920
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Authorized Official
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Title or Position | PRESIDENT OF THE CORPORATION
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Name | JOSHUA CH TAN
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Credential | MD
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Telephone | 808-949-8988
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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 | 7552
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License Number State | HI
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