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General NPI Number Information
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NPI Number | 1962608539
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Entity Type | Individual
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Provider Name | SABRINA K.G. TAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 475 PIONEER AVE
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City | WOODLAND
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State | CA
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Zip | 95776-4905
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Country | US
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Telephone | 530-750-5904
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 255228
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City | SACRAMENTO
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State | CA
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Zip | 95865-5228
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Country | US
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Telephone |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MDR-5298
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD60624958
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207RS0010X
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Taxonomy Name | Sports Medicine (Internal Medicine) Physician
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License Number | MD-15762
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License Number State | HI
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C151878
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License Number State | CA
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