Tetris Tan, MD
NPI 1104506005ActiveIndividual· Internal Medicine· Hesperia, CA
Internal Medicine (MD) in Hesperia, California, licensed in CA, with an NPI issued in July 2023. Enrolled in Medicare as practitioner - internal medicine.
Overview
| NPI | 1104506005 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MD |
| Sole proprietor | Yes |
| NPI issued | Jul 25, 2023 |
| Last updated in NPPES | Sep 21, 2026 |
| Certified by provider | Sep 21, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | A209622 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Internal Medicine (CA) |
|---|
Education and affiliations
| Graduation year | 2020 |
|---|---|
| Medicare specialty | Internal Medicine |
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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