| Lam Md | |
|
2492 Walnut Ave Ste 100 Tustin CA 92780-6953 | |
| (714) 709-8000 | |
| (714) 709-8080 |
| Full Name | Lam Md |
|---|---|
| Speciality | Clinic/Center |
| Location | 2492 Walnut Ave Ste 100, Tustin, California |
| Authorized Official Name and Position | Carrie Jasmine Lam (PRESIDENT) |
| Authorized Official Contact | 6269934034 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lam Md 2492 Walnut Ave Ste 100 Tustin CA 92780-6953 Ph: (714) 709-8000 | Lam Md 2492 Walnut Ave Ste 100 Tustin CA 92780-6953 Ph: (714) 709-8000 |
| NPI Number | 1184277063 |
|---|---|
| Provider Enumeration Date | 07/19/2019 |
| Last Update Date | 10/01/2019 |
| Medicare PECOS PAC ID | 5496184715 |
|---|---|
| Medicare Enrollment ID | O20200407001637 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184277063 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Stella Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073053740 PECOS PAC ID: 1951667849 Enrollment ID: I20190910000831 |
| Provider Name | Carrie Jasmine Lam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669822284 PECOS PAC ID: 7618208356 Enrollment ID: I20200407001797 |
| Provider Name | Jeremy Lam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083140172 PECOS PAC ID: 5294165510 Enrollment ID: I20200428001018 |
| Provider Name | Kellie Hang Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932886991 PECOS PAC ID: 4486090289 Enrollment ID: I20240315000617 |
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