| NPI | 1134277569 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2007-01-08 |
| Last Updated | 2007-07-09 |
| Mailing Address | 12980 Frederick St, Suite D Moreno Valley, CA 92553-5263 United States Phone: (951) 485-2744 📍 View Map |
| Primary Practice Address | 12980 Frederick St, Suite D Moreno Valley, CA 92553-5263 United States Phone: (951) 485-2744 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | CA | 00A454161 | — |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 207R00000X – Internal Medicine | CA | A45416 |
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About NPI 1134277569
Antonio A. Tan M.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1134277569. The primary specialty listed is Internal Medicine. The provider is located in Moreno Valley, CA. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2007-01-08. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1134277569?
NPI 1134277569 belongs to Antonio A. Tan M.D., a Internal Medicine in Moreno Valley, CA. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1134277569 active?
The current status of NPI 1134277569 in the NPPES registry is Active. The record was last updated on 2007-07-09.
What specialty is NPI 1134277569?
NPI 1134277569 is classified under the taxonomy Internal Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1134277569?
You can verify NPI 1134277569 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1134277569?
The primary practice address on file for NPI 1134277569 is 12980 Frederick St, Moreno Valley, CA 92553-5263. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1134277569 issued?
NPI 1134277569 was first issued (enumerated) on 2007-01-08. The NPPES record was last updated on 2007-07-09.
Practice Location Map
Antonio A. Tan is located at 12980 Frederick St, Moreno Valley, CA. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Antonio A. Tan. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1134277569. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Internal Medicine | A45416 | CA |