Organization
JOHN W. TAM PODIATRY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN W TAM D.P.M. (PRESIDENT)
(626) 914-4661
Entity
Organization
Contact information
Practice address
222 E ROUTE 66, GLENDORA, CA 91740-6241
(626) 914-4661
(626) 335-1840
Mailing address
222 E ROUTE 66, GLENDORA, CA 91740-6241
(626) 914-4661
(626) 335-1840
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E2153
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E21530
—
CA
01
—
4139600001
MEDICARE DME
CA
Enumeration date
10/25/2005
Last updated
02/02/2008
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