Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | G66009 | CA |
NPI | 1013942952 |
---|---|
Provider Name | Dr. Jonathan Nei-Kim Tam |
First Address | Pasadena, CA 91106-1934 |
Second Address | Pasadena, CA 91106-1934 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 03/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G660091 | (05) | CA |
00G660094 | (05) | CA |
F01868 | (02) |