Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A139987 | CA |
N | 111NI0900X | Internist | A139987 | CA |
Y | 207RH0003X | Hematology & Oncology | A139987 | CA |
NPI | 1053739805 |
---|---|
Provider Name | Dr. Eric Leon Tam |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90089-2203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2014 |
Last Update Date | 29/08/2020 |