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MAVERICK TAN
NPI 1922785492
Physician Assistant in Fullerton, CA

Active since June 28, 2023
2575 YORBA LINDA BLVD, FULLERTON, CA 92831(714) 992-7808 Get Directions Write a Review

NPPES record last updated: June 28, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Maverick Tan NPPES

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

MAVERICK TAN (NPI 1922785492) is an individual physician assistant in Fullerton, California and active in the NPI registry since June 2023.

NPPES Registry Identity

NPI1922785492
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMAVERICK TAN
Location Address2575 YORBA LINDA BLVDFullerton, CA 92831-1615
Mailing Address2575 Yorba Linda BlvdFullerton, CA 92831-1615 · (714) 992-7808
Phone(714) 992-7808
Sole ProprietorYes
Enumeration DateJune 28, 2023
NPPES CertifiedJune 28, 2023
✔ NPI 1922785492 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
2575 YORBA LINDA BLVD, Fullerton, CA 92831
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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.

RACHEL JONES
Physician Assistant (Medical)
2575 YORBA LINDA BLVD
FULLERTON, CA 92831
Orange County (714) 449-7400
ONELKA DEVHARA DUNSFORD
Student in an Organized Health Care Education/Training Program
2575 YORBA LINDA BLVD
FULLERTON, CA 92831
Orange County (714) 449-7400
HANNAH HAHN
Physician Assistant
2575 YORBA LINDA BLVD
FULLERTON, CA 92831
Orange County (714) 449-7400
AMY WU
Physician Assistant
2575 YORBA LINDA BLVD
FULLERTON, CA 92831
Orange County (213) 550-7936
CASSIDY SPILLETT
Student in an Organized Health Care Education/Training Program
2575 YORBA LINDA BLVD
FULLERTON, CA 92831
Orange County (714) 449-7400
DR. REGINA SEEN WON GARRIOTT O.D.
Optometrist
2575 YORBA LINDA BLVD
FULLERTON, CA 92831
Orange County (714) 992-7870
GUADALUPE VEGA
Student in an Organized Health Care Education/Training Program
2575 YORBA LINDA BLVD
FULLERTON, CA 92831
Orange County (714) 449-7400
RILEY BENNYWORTH
Student in an Organized Health Care Education/Training Program
2575 YORBA LINDA BLVD
FULLERTON, CA 92831
Orange County (714) 449-7400

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 Maverick Tan's NPI number?

The NPI number for Maverick Tan is 1922785492. It was assigned to this individual provider in the NPPES registry on June 28, 2023.

Where is Maverick Tan located?

Maverick Tan practices at 2575 Yorba Linda Blvd, Fullerton, CA 92831. The listed phone number is (714) 992-7808.

What is Maverick Tan's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Maverick Tan was last updated on June 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.