Provider Type Icon

THOMAS L. VANDER LAAN M.D. AMC NPI 1972709376


NPI Information

NPI: 1972709376
Provider Name: THOMAS L. VANDER LAAN, M.D., AMC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
50 BELLEFONTAINE ST
STE 303
PASADENA, CA
ZIP 91105
Phone: (626) 793-4136
Get Directions

THOMAS L. VANDER LAAN, M.D., AMC is a specialist in Pasadena, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. THOMAS L. VANDER LAAN, M.D., AMC NPI is 1972709376. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

50 BELLEFONTAINE ST
STE 303
PASADENA, CA
ZIP 91105-132
Phone: (626) 793-4136
Fax: (626) 793-8279

The provider's authorized official is Thomas L Vander Laan .
The authorized official title is Director-physician and has the following contact phone number (626) 793-4136.

The enumeration date for this NPI number is 6/22/2007 and was last updated on 4/1/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistG44443CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100G444430MEDICAIDCALIFORNIA
2W1289MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIATYPE 2
3WG44443BMEDICARE PINCALIFORNIA
4WG44443BMEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAPPIN
5W1289OTHERCALIFORNIAMEDICARE PTAN
6E55955MEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.