JONATHAN TAM MD NPI 1619133600

NPI Information

NPI: 1619133600
Provider Name: JONATHAN TAM, MD
Classification: Allergy & Immunology - 207KA0200X
Entity Type: Individual

Specialization: Allergy

PECOS Registration: Yes

Address:
4650 W SUNSET BLVD
MS#75
LOS ANGELES, CA
ZIP 90027
Phone: (323) 361-2501
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Jonathan Tam, MD is an allergy allergy immunology in Los Angeles, CA with 17 years of experience. The provider is a physician who specializes in the diagnosis, treatment, and management of allergies. Source: National Uniform Claim Committee Jonathan Tam, MD NPI is 1619133600. 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:

4650 W SUNSET BLVD
MS#75
LOS ANGELES, CA
ZIP 90027-062
Phone: (323) 361-2501
Fax: (323) 361-1191

The NPI 1619133600 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/30/2008 and was last updated on 6/17/2015.

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	208000000X	Pediatrics		125-052818	ILLINOIS	No
2	208000000X	Pediatrics		54495	WISCONSIN	No
3	207KA0200X	Allergy & Immunology	Allergy	A125923	CALIFORNIA	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	Other Provider Identifier Issuer
1	125-052818	OTHER	ILLINOIS	ILLINOIS LICENSE

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

NPI Synchronization or Removal

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