Provider Demographics
NPI:1467193284
Name:TAM, LYDIA TIN-WEI (MD)
Entity type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:TIN-WEI
Last Name:TAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 16TH STREET, 4TH FLOOR BOX 0110
Mailing Address - Street 2:DEPT OF PEDIATRICS, UNIV OF CALIFORNIA SAN FRANCISCO
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158
Mailing Address - Country:US
Mailing Address - Phone:415-476-3565
Mailing Address - Fax:
Practice Address - Street 1:550 16TH STREET, 4TH FLOOR BOX 0110
Practice Address - Street 2:UNIVERSITY OF CALIFORNIA SAN FRANCISCO
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158
Practice Address - Country:US
Practice Address - Phone:415-476-3565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61298437208000000X
390200000X
CAA2020412080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program