DR. MANUEL PAVIA TAN M.D. NPI 1396939096

NPI Information

NPI: 1396939096
Provider Name: DR. MANUEL PAVIA TAN, M.D.
Classification: General Practice - 208D00000X
Entity Type: Individual
Address:
4351 E LOHMAN AVE
STE 301
LAS CRUCES, NM
ZIP 88011
Phone: (575) 532-8900
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DR. Manuel Pavia Tan, M.D. is a general practice in Las Cruces, NM. DR. Manuel Pavia Tan, M.D. NPI is 1396939096. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4351 E LOHMAN AVE
STE 301
LAS CRUCES, NM
ZIP 88011-259
Phone: (575) 532-8900
Fax: (575) 532-8910

The enumeration date for this NPI number is 9/5/2007 and was last updated on 5/7/2008.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice		93164	NEW MEXICO	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	F9028	MEDICAID	NEW MEXICO
2	B43661	MEDICARE UPIN
3	$$$$$$$$$	MEDICARE PIN

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: 11/14/2023

NPI Synchronization or Removal

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