Tam, Tackson

Tam, Tackson is an individual health care provider with primary practice located at 1010 W La Veta Ave Ste 750 , Orange CA 92868-4312. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Tam, Tackson can be contacted via phone (714) 361-6600.

Contact Information

Primary practice address
1010 W La Veta Ave Ste 750 Orange CA 92868-4312
Fax: (714) 919-8804
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X G70073 California

Profile Details

NPI number 1548239635
LBN Legal business name Tam, Tackson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Nov 11th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548239635 NPPES
California Other 1912919804 MEDI-CAL
California Other 110200071 MEDI-CAL
California Other 1912919804 MEDI-CAL
California Other CG5665 MEDI-CAL
California Other W1514 MEDI-CAL

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