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NPI Code Detail

MEDICARE: FRANK M. TAN MD & JULIA K. LAM MD, A MEDICAL CORP.

MEDICARE: FRANK M. TAN MD & JULIA K. LAM MD, A MEDICAL CORP.
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
12084P0802XAddiction Psychiatry PhysicianG31393CA
22084P0804XChild & Adolescent Psychiatry PhysicianG31393CA

General Provider Information

NPI Number : 1164614699
Entity Type Code : Organization
Provider Name (Legal Business Name) : FRANK M. TAN MD & JULIA K. LAM MD, A MEDICAL CORP.
Provider Business Mailing Address
First Line : 1823 SAWTELLE BLVD
Second Line : SUITE 1
City : LOS ANGELES
State : CA
Zip : 90025-5532
Country : US
Telephone Number : 310-826-3180
Fax Number : 310-454-6422
Provider Business Practice Location Address
First Line : 1823 SAWTELLE BLVD
Second Line : SUITE 1
City : LOS ANGELES
State : CA
Zip : 90025-5532
Country : US
Telephone Number : 310-826-3180
Fax Number : 310-454-6422
Authorized Official
Title or Position : DIRECTOR
Name : DR. FRANK MARDEN TAN
Credential : M.D.
Telephone Number : 310-826-3180
Provider Enumeration Date : 08/17/2007
Last Update Date : 08/17/2007

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