Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Justin Tam SIU, MD

Individual provider Family Medicine Physician · NPI 1407542467

Justin Tam SIU, MD is a Family Practice in Los Angeles, California. Qualified in 2023, 3 years ago. Works from 2 locations. Licensed in California.

Years since qualifying
3
Licensed in
CA
In the registry since
2023
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1520 San Pablo St Ste 1300
Los Angeles, CA 90033-5312
Phone: (323) 442-5900
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1245 16th St Ste 309, Santa Monica, CA 90404-1239 — (310) 319-4377

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence A198786 (CA)

Record details

NPI number1407542467
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 13, 2023
Last updated in NPPESJuly 9, 2026
Certification dateJuly 9, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated

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