Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Gordon Tan, MD

Individual provider Pediatrics Physician · NPI 1659662583

Dr. Gordon Tan, MD is a Pediatrics Physician in Moreno Valley, California. Licensed in California. Registered with an NPI since 2011.

Licensed in
CA
In the registry since
2011
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

12815 Heacock St
Moreno Valley, CA 92553-2836
Phone: (951) 601-6399
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence A122192 (CA)

Record details

NPI number1659662583
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 26, 2011
Last updated in NPPESNovember 30, 2024
Certification dateNovember 30, 2024
Mailing address12815 Heacock St, Moreno Valley, CA 92553-2836

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