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NPI Code Detail

MEDICARE: CHYANSONG J TZAN MD

MEDICARE: CHYANSONG J TZAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology PhysicianL0669TX
2207L00000XAnesthesiology PhysicianC52948CA

General Provider Information

NPI Number : 1184612210
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHYANSONG J TZAN MD
Provider Business Mailing Address
First Line : PO BOX 788
Second Line :
City : HEMET
State : CA
Zip : 92546-0788
Country : US
Telephone Number : 951-929-6260
Fax Number : 951-765-2855
Provider Business Practice Location Address
First Line : 250 S GRAND AVE
Second Line :
City : GLENDORA
State : CA
Zip : 91741-4218
Country : US
Telephone Number : 626-963-8411
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2005
Last Update Date : 09/20/2016

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