Active NPI
Wing Yin Tam, M.S.O.M
- Acupuncturist
- Valley Village, CA
National Provider Identifier
1619033230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC 9037
- Practice address
- 12626 Riverside Dr
Suite 508
Valley Village, CA 91607-3420 - Phone
- (626) 688-1439
- NPI assigned
- Dec 28, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC 9037 | CA | Primary |
Addresses
Primary practice location
12626 Riverside Dr
Suite 508
Valley Village, CA 91607-3420
Mailing address
12626 Riverside Dr
Suite 508
Valley Village, CA 91607-3420
Phone (626) 688-1439
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 56-260-9243 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC 9037 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398470400000",
"number": "1619033230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12626 RIVERSIDE DR",
"address_2": "SUITE 508",
"city": "VALLEY VILLAGE",
"state": "CA",
"postal_code": "916073420",
"telephone_number": "626-688-1439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12626 RIVERSIDE DR",
"address_2": "SUITE 508",
"city": "VALLEY VILLAGE",
"state": "CA",
"postal_code": "916073420",
"telephone_number": "626-688-1439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAM",
"first_name": "WING",
"middle_name": "YIN",
"name_prefix": "Miss",
"credential": "M.S.O.M",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-28",
"last_updated": "2014-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC 9037",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "56-260-9243",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Valley Village, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.