DR. KENNETH I-CHIEN TAN (NPI# 1780631788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780631788 |
| Entity Type | Individual |
| Full Name | DR. KENNETH I-CHIEN TAN |
| Credential | M.D. |
| Practice Address |
3880 S. Bascom Avenue #208 San Jose CA 95124-2675 |
| Mailing Address |
15680 Shannon Hts Los Gatos CA 95032-5723 |
| Practice Telephone | 4083778100 |
| Practice Fax Number | 4083773044 |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
G60594 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699039594 | Kenneth Shu-wen Tan | Family Medicine | 3217 S Providence Rd, Columbia, MO 65203-3639 | 2012-06-26 |
| 1306008834 | Kenneth Tan Tan | Radiology | 5820 Oberlin Dr, Ste. 205, San Diego, CA 92121-3742 | 2008-06-26 |
| 1396821815 | Kenneth C. Tan | Internal Medicine | 7520 Arroyo Cir, Gilroy, CA 95020-7303 | 2006-10-27 |
| 1013918283 | Kenneth Tan | Family Medicine | 4300 Rose Dr, Yorba Linda, CA 92886-2026 | 2005-08-09 |
| Street Address |
3880 S. BASCOM AVENUE #208 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95124-2675 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720548894 | Talkawhile Child and Family Therapy Center PC | Marriage & Family Therapist | 2577 Samaritain Drive, Suite 715, San Jose, CA 95124 | 2019-03-23 |
| 1558847129 | Anne Marie Hamilton | Nurse Practitioner | 2851 Samaritan Dr., San Jose, CA 95124 | 2018-07-17 |
| 1619488665 | Vicky Nguyen | Dentist | 3994 S Bascom Ave # 5, San Jose, CA 95124 | 2017-10-17 |
| 1255840625 | Emmanuel Rohani | Pharmacist | 4623 Fallstone Court, San Jose, CA 95124 | 2017-09-28 |
| 1669928933 | Karlena Lara-otero | Genetic Counselor, MS | 2589 Samaritan Drive, Floor 3, Mail Code: 7532, San Jose, CA 95124 | 2016-08-28 |
| 1982081287 | Shraddha Patel | Dietitian, Registered | 3535 Ross Ave Ste 202, San Jose, CA 95124 | 2015-05-06 |
| 1679966576 | Andrew Francis | Marriage & Family Therapist | 1936 Camden Ave Ste 5a, San Jose, CA 95124 | 2015-03-17 |
| 1164835914 | Addiction Recovery Center | Clinic/Center | 3880 S. Bascom Ave #206, San Jose, CA 95124 | 2014-06-10 |
| 1780005199 | Swathi Balantrapu | Physical Therapist | 14587 Branham Ln, San Jose, CA 95124 | 2014-01-02 |
| 1033405196 | Rick Li Pan | Dentist | 3535 Ross Ave, #201, San Jose, CA 95124 | 2011-06-27 |
| Find all providers in zip 95124 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| 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/certification - 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 |
|---|---|---|---|---|
| 1770546723 | Lota F. Viray | Pediatrics | 3880 S Bascom Ave, San Jose, CA 95124-2674 | 2006-04-10 |
| 1205049376 | Sridevi Venigalla | Pediatrics | 2505 Samaritan Dr, Suite 304, San Jose, CA 95124-4006 | 2007-05-07 |
| 1699717041 | Glenn H Desandre | Pediatrics | 751 S Bascom Ave, San Jose, CA 95128-2604 | 2006-06-11 |
| 1912951880 | Bindya S Singh | Pediatrics | 135 N Jackson Ave, San Jose, CA 95116-1917 | 2006-05-22 |
| 1689626996 | Richard James Powers | Pediatrics | 3880 S Bascom Ave, Suite 208, San Jose, CA 95124-2674 | 2006-05-16 |
| 1700841269 | Tungho Wang | Pediatrics | 3880 S Bascom Ave, San Jose, CA 95124-2675 | 2006-04-19 |
| 1376506261 | Meera N Sankar | Pediatrics | 3880 S Bascom Ave, Suite 208, San Jose, CA 95124-2674 | 2006-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699316695 | Neonatal Hospitalist Group, Inc | Pediatrics | 501 S Buena Vista St Nicu, Burbank, CA 91505-4809 | 2019-10-01 |
| 1619418936 | Natalie Hoi-man Chan | Pediatrics | 2516 Stockton Blvd Fl 2, Sacramento, CA 95817-2208 | 2017-03-20 |
| 1427502186 | George Francis Tidmarsh | Pediatrics | 10182 Telesis Ct, San Diego, CA 92121-4760 | 2016-08-11 |
| 1477904530 | Lida Irene Zeinali | Pediatrics | 2315 Stockton Blvd # 5, Sacramento, CA 95817-2201 | 2016-06-29 |
| 1104214196 | Estrellita Rubio Reyes | Pediatrics | 3908 Beverly Blvd., Los Angeles, CA 90004 | 2014-12-30 |
| 1871921718 | Mirin Hemasilpin | Pediatrics | 22554 Ventura Blvd Ste 117, Woodland Hills, CA 91364-1436 | 2013-10-30 |
| 1588937353 | Jeffrey Joseph Pomerance | Pediatrics | 351 W Northridge Ave, Glendora, CA 91741-2036 | 2012-02-09 |
| 1447549225 | Jimmy Thuan Nguyen | Pediatrics | 5621 W Barbette Ave, Santa Ana, CA 92704-1015 | 2011-04-01 |
| 1699085134 | Rosemary Leake | Pediatrics | 2 Crest Rd W, Rolling Hills, CA 90274-5003 | 2010-10-18 |
| 1811200124 | Katrina Tan Ibonia | Pediatrics | 9300 Valley Childrens Pl # Se21, Madera, CA 93636-8762 | 2010-07-16 |
| Find all providers with the same taxonomy | ||||
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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.