Maverick Tan
Maverick Tan is a Physician Assistant in Fullerton, California. Practices as a sole proprietor. Registered with an NPI since 2023.
- In the registry since
- 2023
Practice location Address checks out
2575 Yorba Linda BlvdFullerton, CA 92831-1615
Phone: (714) 992-7808
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Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X |
|---|
Record details
| NPI number | 1922785492 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | June 28, 2023 |
| Last updated in NPPES | June 28, 2023 |
| Certification date | June 28, 2023 |
| Mailing address | 2575 Yorba Linda Blvd, Fullerton, CA 92831-1615 |
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