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NPI Code Detail

MEDICARE: PERLITA K TAM MD

MEDICARE: PERLITA K 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
1208000000XPediatrics PhysicianMD061177LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1467497768
Entity Type Code : Individual
Provider Name (Legal Business Name) : PERLITA K TAM MD
Provider Business Mailing Address
First Line : PO BOX AD
Second Line :
City : YUBA CITY
State : CA
Zip : 95992-1396
Country : US
Telephone Number : 530-751-3769
Fax Number : 530-751-1237
Provider Business Practice Location Address
First Line : 4941 OLIVEHURST AVE
Second Line :
City : OLIVEHURST
State : CA
Zip : 95961-4225
Country : US
Telephone Number : 530-413-4611
Fax Number : 530-743-5770
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2006
Last Update Date : 03/18/2014

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Directions to “ PERLITA K TAM MD” Practice Location

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