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CISSY M. TAN MD
NPI 1457403826
Surgery - Plastic and Reconstructive Surgery in San Diego, CA

Active since January 17, 2007PECOS Enrolled
4647 ZION AVE, SAN DIEGO, CA 92120(619) 528-5000 Get Directions Write a Review

NPPES record last updated: November 29, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Cissy M. Tan Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CISSY M. TAN MD (NPI 1457403826) is an individual plastic and reconstructive surgery provider in San Diego, California, licensed in California (A46348) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1457403826
Entity TypeIndividualFemale
Primary Taxonomy2086S0122X
Provider Legal NameCISSY M. TANCredential: MD
Location Address4647 ZION AVESan Diego, CA 92120-2507
Mailing Address4647 Zion AveSan Diego, CA 92120-2507 · (619) 528-5000
Phone(619) 528-5000
Sole ProprietorNo
Enumeration DateJanuary 17, 2007
Last NPPES UpdateNovember 29, 2021
✔ NPI 1457403826 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
License✔ Licensed in CA · A46348
Definition
A surgeon who specializes in plastic and reconstructive surgery.
4647 ZION AVE, San Diego, CA 92120
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Cissy M. Tan Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANN MARIE PENA MD
Obstetrics & Gynecology
4647 ZION AVE
SAN DIEGO, CA 92120
San Diego County (619) 528-5000
DR. SHWETA WARNER M.D.
Internal Medicine (Infectious Disease)
4647 ZION AVE
SAN DIEGO, CA 92120
San Diego County (619) 221-6258
DR. MATTHEW JAMES ROOSEVELT M.D.
Internal Medicine
4647 ZION AVE, DEPARTMENT OF HOSPITAL MEDICINE
SAN DIEGO, CA 92120
San Diego County (619) 952-5091
RICHARD FUNG
Pharmacist
4647 ZION AVE
SAN DIEGO, CA 92120
San Diego County (626) 278-2749
ARDIS L TASCHNER CRNA
Nurse Anesthetist, Certified Registered
4647 ZION AVE
SAN DIEGO, CA 92120
San Diego County (619) 528-5000
JEANNE HAGER DONAHUE LCSW
Social Worker (Clinical)
4647 ZION AVE
SAN DIEGO, CA 92120
San Diego County (619) 528-5323
DAVID M. LEVINE MD
Internal Medicine (Pulmonary Disease)
4647 ZION AVE
SAN DIEGO, CA 92120
San Diego County (619) 528-5000
DALE K. LIEU MD
Internal Medicine (Infectious Disease)
4647 ZION AVE
SAN DIEGO, CA 92120
San Diego County (619) 528-5000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Cissy Tan's NPI number?

The NPI number for Cissy Tan is 1457403826. It was assigned to this individual provider in the NPPES registry on January 17, 2007.

Where is Cissy Tan located?

Cissy Tan practices at 4647 Zion Ave, San Diego, CA 92120. The listed phone number is (619) 528-5000.

What is Cissy Tan's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Is Cissy Tan enrolled in Medicare?

Yes. Cissy Tan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Cissy Tan was last updated on November 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.