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NPI Code Detail

MEDICARE: LONG YIN TAM PA

MEDICARE:   LONG YIN TAM  PA
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
1363A00000XPhysician AssistantPA62454CA

General Provider Information

NPI Number : 1225741382
Entity Type Code : Individual
Provider Name (Legal Business Name) : LONG YIN TAM PA
Provider Business Mailing Address
First Line : 2211 E ORANGEWOOD AVE # UNITE429
Second Line :
City : ANAHEIM
State : CA
Zip : 92806-6540
Country : US
Telephone Number : 510-612-8813
Fax Number :
Provider Business Practice Location Address
First Line : 3401 AERO JET AVE
Second Line :
City : EL MONTE
State : CA
Zip : 91731-2801
Country : US
Telephone Number : 626-286-8700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2023
Last Update Date : 04/14/2025

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Directions to “ LONG YIN TAM PA” Practice Location

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