Basic Information
| Provider Information | |||||||||
| NPI: | 1679632103 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAN | ||||||||
| FirstName: | KHAI LING | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 6730 | ||||||||
| Address2: | |||||||||
| City: | CHANDLER | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852466730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4809476480 | ||||||||
| FaxNumber: | 4808572667 | ||||||||
| Practice Location | |||||||||
| Address1: | 1634 S PRIEST DR | ||||||||
| Address2: | BLDG 3, STE 101 | ||||||||
| City: | TEMPE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852816204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4809176480 | ||||||||
| FaxNumber: | 4808572667 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/08/2006 | ||||||||
| LastUpdateDate: | 07/02/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 45996 | AZ | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.