KATHERINE K. TAN (NPI# 1477631554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477631554 |
| Entity Type | Individual |
| Full Name | KATHERINE K. TAN |
| Credential | MD |
| Practice Address |
3400 Delta Fair Blvd Antioch CA 94509-4004 |
| Mailing Address |
1800 Harrison St Fl 7 Oakland CA 94612-3429 |
| Practice Telephone | 9257795000 |
| Mailing Telephone | 5106256262 |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | A51983 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A519830 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639737414 | Katherine Co Tan | Dentist | 7850 Stockton Blvd Ste 160, Sacramento, CA 95823-4387 | 2019-06-05 |
| 1588706477 | Katherine Hudson Tan | Physical Therapist | 147 W 24th St, 7th Floor, New York, NY 10011-1911 | 2007-02-14 |
| 1689151037 | Katherine Tan | Registered Nurse | 4417 N 6th St, Philadelphia, PA 19140-2319 | 2018-07-27 |
| 1306977590 | Katherine Soo Tian Tan | Massage Therapist | 570 Ocean Dr, Holistic Manage & Wellness Clinics # 501, Juno Beach, FL 33408 | 2007-03-08 |
| Street Address |
3400 DELTA FAIR BLVD |
| City | ANTIOCH |
| State | CA |
| Zip Code | 94509-4004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215929914 | Barbara A Rhoades | Nurse Practitioner | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2005-08-18 |
| 1962936849 | Nardip Singh | Pharmacist | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2017-04-17 |
| 1649704743 | Anh X Nguyen | Pharmacist | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2017-04-14 |
| 1104359918 | Borey Som | Pharmacist | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2017-04-07 |
| 1790005015 | Elizabeth Seidler | Dermatology | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2010-06-09 |
| 1699091793 | Allison Townsend Hampton | Pediatrics | 3400 Delta Fair Blvd, Department of Pediatrics, Antioch, CA 94509-4004 | 2010-04-14 |
| 1063746998 | Athena Panzar | Counselor | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2009-09-24 |
| 1083859888 | Philip Song | Dermatology | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2008-12-08 |
| 1033319215 | Sanaz Stacy Aboutalebi-simon | Optometrist | 3400 Delta Fair Blvd, The Permanente Medical Group, Inc., Antioch, CA 94509-4004 | 2007-07-24 |
| 1700099264 | Derek S Mongold | Family Medicine | 3400 Delta Fair Blvd, Antioch, CA 94509-4004 | 2007-05-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932733243 | A Step Above, LLC | Clinic/Center | 3648 Delta Fair Blvd., Antioch, CA 94509 | 2020-02-25 |
| 1134751167 | Dr. Jeffrey A Saladin, Dental Corporation | Dentist | 3600 Delta Fair Blvd, Antioch, CA 94509 | 2020-02-07 |
| 1962040865 | Melay Goitom | Behavioral Analyst | 3104 Delta Fair Boulevard, Antioch, CA 94509 | 2019-12-11 |
| 1518525062 | James Joseph Cook | Counselor | 624 W. 14th Street B, Antioch, CA 94509 | 2019-05-30 |
| 1922576438 | Wazma Matiee | Behavioral Analyst | 2009 Asilomar Dr., Antioch, CA 94509 | 2018-11-02 |
| 1346722360 | Dharma Rachelle Yancy | Behavioral Analyst | 3401 Delta Fair Blvd, Antioch, CA 94509 | 2018-09-06 |
| 1912489931 | Cristian Cruz | Behavioral Analyst | 3100-3104 Delta Fair Blvd, Antioch, CA 94509 | 2018-09-06 |
| 1780174052 | Melissa Sue Rossi | Counselor | 3701 Lone Tree Way Ste 7a, Antioch, CA 94509 | 2018-05-13 |
| 1033638085 | Elizabeth Marie Artola | Counselor | 1915 D Street, Antioch, CA 94509 | 2017-09-11 |
| 1144748690 | Andrea Michelle Newberry | Counselor | 55 E.18th St, Antioch, CA 94509 | 2017-09-05 |
| Find all providers in zip 94509 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194134049 | Abbas Mahdavi | Pediatrics | 3700 Lone Tree Way # 3, Antioch, CA 94509-6018 | 2014-08-05 |
| 1861800633 | Abbas Mahdavi Md Inc | Pediatrics | 3700 Sunset Ln Ste 3, Antioch, CA 94509-6123 | 2014-07-24 |
| 1679889448 | Lisa Ann Hills | Pediatrics | 4053 Lone Tree Way Ste 101, Antioch, CA 94531-6210 | 2010-08-31 |
| 1629081005 | Irmeen Musharraf Ashraf | Pediatrics | 3901 Lone Tree Way Ste 211, Antioch, CA 94509-6200 | 2006-08-15 |
| 1376562611 | Franklin Charles Buckner Jr. | Pediatrics | 4816 Pineview Way, Antioch, CA 94531 | 2006-07-18 |
| 1528454238 | Shelley Katherine Ross-li | Pediatrics | 3901 Lone Tree Way Ste 211, Antioch, CA 94509-6200 | 2015-04-09 |
| 1730522954 | Andre Smiljic | Pediatrics | 4501 Sand Creek Rd, Antioch, CA 94531 | 2013-04-08 |
| 1255622890 | Macy Kim Lau | Pediatrics | 4501 Sand Creek Rd, Antioch, CA 94531-8687 | 2011-05-01 |
| 1215256599 | Susan Lyla Adham | Pediatrics | 4053 Lone Tree Way, Suite 101, Antioch, CA 94531-6210 | 2010-05-25 |
| 1699091793 | Allison Townsend Hampton | Pediatrics | 3400 Delta Fair Blvd, Department of Pediatrics, Antioch, CA 94509-4004 | 2010-04-14 |
| Find all providers in ANTIOCH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.