MEDICARE: RACHEL TAM

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	363LF0000X	Family Nurse Practitioner	95025304	CA
2	363LF0000X	Family Nurse Practitioner	F03230284	CA

General Provider Information

NPI Number	:	1326828740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL TAM

Provider Business Mailing Address
First Line	:	165 ALTO LOMA
Second Line	:
City	:	MILLBRAE
State	:	CA
Zip	:	94030-2161
Country	:	US
Telephone Number	:	415-218-4379
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 UNIVERSITY AVE STE 101
Second Line	:
City	:	EAST PALO ALTO
State	:	CA
Zip	:	94303-2213
Country	:	US
Telephone Number	:	650-618-6010
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2023
Last Update Date	:	10/03/2023

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Directions to “ RACHEL TAM ” Practice Location

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