Individual
MS. CONNIE MING TAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
22110 ROSCOE BLVD, CANOGA PARK, CA 91304-3845
(818) 887-5515
Mailing address
22110 ROSCOE BLVD, CANOGA PARK, CA 91304-3845
(818) 887-5515
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA19235
CA
Other
Enumeration date
06/26/2007
Last updated
07/08/2007
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