Provider Demographics
NPI:1154960334
Name:TAM, ALAN K (NP)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:K
Last Name:TAM
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 STOCKTON ST STE 202
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-1619
Mailing Address - Country:US
Mailing Address - Phone:650-718-5763
Mailing Address - Fax:
Practice Address - Street 1:950 STOCKTON ST STE 202
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-1619
Practice Address - Country:US
Practice Address - Phone:650-718-5763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-05
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013093363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95013093OtherCALIFORNIA FAMILY NURSE PRACTITIONER