Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | A108259 | CA |
NPI | 1699972042 |
---|---|
Provider Name | Giang-Tuyet Nguyen Lam |
First Address | Huntington Beach, CA 92647-2951 |
Second Address | Redlands, CA 92373 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 17/03/2018 |