Provider Demographics
NPI:1518657550
Name:TAN, NEMUEL BIEJAY (DC)
Entity Type:Individual
Prefix:
First Name:NEMUEL
Middle Name:BIEJAY
Last Name:TAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5023 HARTWICK ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-2306
Mailing Address - Country:US
Mailing Address - Phone:323-317-2650
Mailing Address - Fax:
Practice Address - Street 1:5023 HARTWICK ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-2306
Practice Address - Country:US
Practice Address - Phone:323-317-2650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-12
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC35175111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor