| Ying Ming Benjamin Tan, MD | |
|
1095 Marshall Way Ste 202, Placerville, CA 95667-5722 | |
| (530) 626-3682 | |
| (530) 748-0325 |
| Full Name | Ying Ming Benjamin Tan |
|---|---|
| Gender | Male |
| Speciality | Surgery |
| Location | 1095 Marshall Way Ste 202, Placerville, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538699913 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | A159195 (California) | Primary |
| Entity Name | Marshall Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962506097 PECOS PAC ID: 7517875859 Enrollment ID: O20031208001095 |
| Mailing Address | Practice Location Address |
|---|---|
| Ying Ming Benjamin Tan, MD Po Box 45680, San Francisco, CA 94145-3625 Ph: (530) 626-2787 | Ying Ming Benjamin Tan, MD 1095 Marshall Way Ste 202, Placerville, CA 95667-5722 Ph: (530) 626-3682 |
Dr. Robert Francis Kissling Iii, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 7040 Amber Way, Placerville, CA 95667 Phone: 909-213-0806 | |
Delandy Mcconnell, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1095 Marshall Way Ste 202, Placerville, CA 95667 Phone: 530-626-3682 Fax: 530-748-0325 | |
Dr. Craig R Thayer, M.D., F.A.C.S. Surgery Medicare: Medicare Enrolled Practice Location: 941 Spring St, Suitea, Placerville, CA 95667 Phone: 530-626-1102 Fax: 530-626-4337 | |
Richard Detwiler, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1095 Marshall Way, Suite 202, Placerville, CA 95667 Phone: 530-626-3682 | |
Robin L Locke, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 1095 Marshall Way, Suite 202, Placerville, CA 95667 Phone: 530-626-3682 | |
John Yongkwon Lee, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1095 Marshall Way, Suite 202, Placerville, CA 95667 Phone: 530-626-3682 |