Provider Demographics
NPI:1841398518
Name:TAN, JAMES H T (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:H T
Last Name:TAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:94-450 MOKUOLA ST
Mailing Address - Street 2:STE 106
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3388
Mailing Address - Country:US
Mailing Address - Phone:808-675-7332
Mailing Address - Fax:813-283-9331
Practice Address - Street 1:332 NEWTOWN RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-1793
Practice Address - Country:US
Practice Address - Phone:757-473-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CODR.0067413207Q00000X
VA0101239190207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC98952Medicare UPIN
VA011816P95Medicare PIN