Antonio Tan (NPI# 1134277569, PAC ID# 9032188446) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1134277569 |
| PAC ID by PECOS | 9032188446 |
| Professional Enrollment ID | I20050106000207 |
| Full Name | Antonio Tan |
| Address |
12980 Frederick St D Moreno Valley CA 92553-5263 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1975 |
| Primary Specialty | INTERNAL MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050022 | RIVERSIDE COMMUNITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 12980 Frederick St D, Moreno Valley, CA 92553-5263 |
| Street Address |
12980 FREDERICK ST D |
| City | MORENO VALLEY |
| State | CA |
| Zip | 92553-5263 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Munish Loomba | Pain Management | 12712 Heacock St, Suite 9a, Moreno Valley, CA 92553-3037 | |
| Ma Angelica T Cuyugan | Nurse Practitioner | Remedial Medical Group | 12730 Heacock St, Suite 4a, Moreno Valley, CA 92553-3040 |
| Andrea M Price | Physician Assistant | Remedial Medical Group | 12730 Heacock St, Moreno Valley, CA 92553-3040 |
| Beverly Chiong | Nurse Practitioner | Remedial Medical Group | 12730 Heacock St, Suite 4a, Moreno Valley, CA 92553-3040 |
| Ahmed M Mahdi | Nurse Practitioner | Remedial Medical Group | 12730 Heacock St, Suite 4a, Moreno Valley, CA 92553-3040 |
| Maxine C Okafor | Nurse Practitioner | Remedial Medical Group | 12730 Heacock St, Suite 4a, Moreno Valley, CA 92553-3040 |
| Aristotle E Santos | Nurse Practitioner | Remedial Medical Group | 12730 Heacock St, Suite 4a, Moreno Valley, CA 92553-3040 |
| Daryell Cushman Ii | Physical Therapy | Adorador Enterprises | 12730 Heacock St, 4b, Moreno Valley, CA 92553-3040 |
| James R Shoemaker | Physical Therapy | Adorador Enterprises | 12730 Heacock St, 4b, Moreno Valley, CA 92553-3040 |
| Pablo Sobero | Family Medicine | 13050 Heacock St, Moreno Valley, CA 92553-3122 | |
| Find all physicians in zip 92553 | |||
| City | MORENO VALLEY |
| Zip Code | 92553 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | MORENO VALLEY + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Antonio Tan.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.