Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | A83230 | CA |
NPI | 1043257769 |
---|---|
Provider Name | Eugene Lam |
First Address | La Quinta, CA 92253-8858 |
Second Address | La Quinta, CA 92253 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 13/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H74184 | (02) |