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NPI Code Detail

MEDICARE: NATHAN TAM

MEDICARE: NATHAN 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
1104100000XSocial WorkerASW133716CA

General Provider Information

NPI Number : 1427912138
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHAN TAM
Provider Business Mailing Address
First Line : 1540 E COLORADO ST
Second Line :
City : GLENDALE
State : CA
Zip : 91205-1514
Country : US
Telephone Number : 818-244-7257
Fax Number :
Provider Business Practice Location Address
First Line : 4760 SEPULVEDA BLVD
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-4820
Country : US
Telephone Number : 310-390-6612
Fax Number : 310-398-5690
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2025
Last Update Date : 12/16/2025

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Directions to “ NATHAN TAM ” Practice Location

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