Individual
DR. TONY YUK MAN TAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1700 COFFEE RD, MODESTO, CA 95355-2803
(209) 579-5628
(209) 579-5637
Mailing address
4490 OAKDALE RD, MODESTO, CA 95357-0800
(209) 404-2261
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G71710
CA
2086S0127X
Trauma Surgery Physician
G71710
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G717100
—
CA
01
—
00G717102
PROVIDER TRANSACTION ACCESS NUMBER (PTAN)
—
Enumeration date
07/03/2006
Last updated
08/24/2023
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