Individual provider Active NPI

Tam Dan DO, M.D.

  • Internal Medicine Physician
  • Torrance, CA
National Provider Identifier
1134540719
Registry record updated Nov 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
133815 Issued in CA
Practice address
1000 W Carson St
Torrance, CA 90502-2004
Phone
(310) 222-5610
NPI assigned
Dec 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 133815 CA Primary

Addresses

Primary practice location

1000 W Carson St
Torrance, CA 90502-2004

Mailing address

1000 W Carson St
Torrance, CA 90502-2004
Phone (310) 222-5610

Other practice location 1

1100 W Stewart Dr
Orange, CA 92868-3849
Phone (714) 633-9111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170511002715 CA Practitioner - Internal Medicine 4385921733 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Wisconsin, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1100 W Stewart Dr
Orange, CA 92868-3849
Phone (714) 633-9111

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

Hospital & facility affiliations

  • Providence St. Joseph Hospital Hospital, Orange, CA, CCN 050069

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
133815CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Nov 12, 2018 Accepting new patients
Providence Medical Foundation CurrentSince Nov 12, 2018 Accepting new patients
County of Los Angeles CurrentSince Apr 1, 2017 Accepting new patients
County of Los Angeles CurrentSince Apr 1, 2017 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

1100 W Stewart Dr
Orange, CA 92868
Phone (714) 532-8620

1000 W Carson St
Torrance, CA 90502
Phone (310) 222-3501

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1388016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1134540719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W CARSON ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022004",
            "telephone_number": "310-222-5610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W CARSON ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022004",
            "telephone_number": "310-222-5610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 W Stewart Dr",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928683849",
            "country_code": "US",
            "telephone_number": "714-633-9111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DO",
        "first_name": "TAM",
        "middle_name": "DAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-26",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "133815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.