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

Kenneth Tan Tan, MD

Individual provider Diagnostic Radiology Physician · NPI 1306008834

Kenneth Tan Tan, MD is a Diagnostic Radiology in San Diego, California. Graduated from University of California, San Francisco School of Medicine in 1988, 38 years ago. Practices with Kc Tan MD Medical Corporation, a 24-clinician group and accepts Medicare assignment. Licensed in Guam and Texas.

Years since qualifying
38
Trained at
University of California, San Francisco School of Medicine
Licensed in
GU, TX
In the registry since
2008
Specialties on file
2
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

5820 Oberlin Dr Ste 205
San Diego, CA 92121-3742
Phone: (877) 570-8362
Fax: (877) 570-8362
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence J6262 (TX)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence M-2019 (GU)

Record details

NPI number1306008834
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJune 26, 2008
Last updated in NPPESDecember 16, 2020
Certification dateDecember 16, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolUNIVERSITY OF CALIFORNIA, SAN FRANCISCO SCHOOL OF MEDICINE
Graduated 1988 (38 years in practice)
Group practice Kc Tan Md Medical Corporation — 24 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations21 on file with Medicare

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