Provider Demographics
NPI:1770532244
Name:TAM, BETTY M (MD)
Entity type:Individual
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First Name:BETTY
Middle Name:M
Last Name:TAM
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Gender:F
Credentials:MD
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Mailing Address - Street 1:5575 W LAS POSITAS BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588
Mailing Address - Country:US
Mailing Address - Phone:925-463-0590
Mailing Address - Fax:925-847-9532
Practice Address - Street 1:1133 EAST STANLEY BLVD
Practice Address - Street 2:# 101
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550
Practice Address - Country:US
Practice Address - Phone:925-454-4280
Practice Address - Fax:925-454-4284
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2011-10-31
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Provider Licenses
StateLicense IDTaxonomies
CAA86417207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I44654Medicare UPIN
00A864170Medicare ID - Type Unspecified