MEDICARE: MICHELLE S. TAM, M.D., INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	A62269	CA

General Provider Information

NPI Number	:	1588687834
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHELLE S. TAM, M.D., INC

Provider Business Mailing Address
First Line	:	1289 E. HILLSDALE BLVD
Second Line	:	SUITE 6
City	:	FOSTER CITY
State	:	CA
Zip	:	94404-1219
Country	:	US
Telephone Number	:	650-312-1000
Fax Number	:	650-523-8800

Provider Business Practice Location Address
First Line	:	1289 E. HILLSDALE BLVD
Second Line	:	SUITE 6
City	:	FOSTER CITY
State	:	CA
Zip	:	94404-1219
Country	:	US
Telephone Number	:	650-312-1000
Fax Number	:	650-523-8800

Authorized Official
Title or Position	:	OFFICER
Name	:	DR. MICHELLE S. TAM
Credential	:	M.D.
Telephone Number	:	650-312-1000

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	08/22/2020

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