| Antonio A. Tan, Md, Professional Corporation | |
|
12980 Frederick St Suite D Moreno Valley CA 92553-5263 | |
| (951) 485-2744 | |
| (951) 485-2749 |
| Full Name | Antonio A. Tan, Md, Professional Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 12980 Frederick St, Moreno Valley, California |
| Authorized Official Name and Position | Rhoda J. Tan (MANAGER / SECRETARY OF P.C.) |
| Authorized Official Contact | 9514852744 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Antonio A. Tan, Md, Professional Corporation 12980 Frederick St Suite D Moreno Valley CA 92553-5263 Ph: (951) 485-2744 | Antonio A. Tan, Md, Professional Corporation 12980 Frederick St Suite D Moreno Valley CA 92553-5263 Ph: (951) 485-2744 |
| NPI Number | 1003870676 |
|---|---|
| Provider Enumeration Date | 04/12/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9133177306 |
|---|---|
| Medicare Enrollment ID | O20050105000392 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003870676 | NPI | - | NPPES |
| 00A454161 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | A45416 (California) | Primary |
| Provider Name | Antonio Tan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134277569 PECOS PAC ID: 9032188446 Enrollment ID: I20050106000207 |
Riverside University Health System Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 26520 Cactus Ave, Moreno Valley, CA 92555 Phone: 951-486-4000 Fax: 951-486-4435 | |
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Planned Parenthood Pacific Southwest Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12900 Frederick St Ste C, Moreno Valley, CA 92553 Phone: 951-222-3101 | |
Joel A Pengson, Md, A Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 23180 Hemlock Ave, Moreno Valley, CA 92557 Phone: 951-243-6460 | |
John Liquete Md Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 14114 Business Center Dr, Suite D, Moreno Valley, CA 92553 Phone: 951-697-1150 | |
Yogendra B Patel,md,inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12980 Frederick St, Suite J, Moreno Valley, CA 92553 Phone: 951-924-9300 Fax: 951-485-0240 |