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NPI Code Detail

MEDICARE: JAYDE NG TAM MD

MEDICARE: JAYDE NG TAM MD
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
1390200000XStudent in an Organized Health Care Education/Training ProgramCA

General Provider Information

NPI Number : 1790624476
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAYDE NG TAM MD
Provider Business Mailing Address
First Line : 200 W ARBOR DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-9000
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 200 W ARBOR DR
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-9000
Country : US
Telephone Number : 858-657-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2026
Last Update Date : 06/16/2026

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Directions to “ JAYDE NG TAM MD” Practice Location

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