Provider Demographics
NPI:1568055077
Name:TAM, KALOK
Entity Type:Individual
Prefix:
First Name:KALOK
Middle Name:
Last Name:TAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38228 PASEO PADRE PKWY APT 11
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-5258
Mailing Address - Country:US
Mailing Address - Phone:510-709-6863
Mailing Address - Fax:
Practice Address - Street 1:38228 PASEO PADRE PKWY APT 11
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-5258
Practice Address - Country:US
Practice Address - Phone:510-709-6863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program