Provider Demographics
NPI:1033407549
Name:TAN, JEFFREY JING (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:JING
Last Name:TAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3857 BIRCH ST STE 3145
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2616
Mailing Address - Country:US
Mailing Address - Phone:510-673-7430
Mailing Address - Fax:844-320-9747
Practice Address - Street 1:1245 WILSHIRE BLVD STE 380
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-4886
Practice Address - Country:US
Practice Address - Phone:213-483-8810
Practice Address - Fax:213-481-1503
Is Sole Proprietor?:No
Enumeration Date:2011-07-18
Last Update Date:2024-04-09
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Provider Licenses
StateLicense IDTaxonomies
CAA135284207W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology