| Doctor Name: | DR. JASON TAI PANG LAM |
| NPI Number: | 1114033040 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | MD11212 |
| Business Practice Address: | 302 California Ave Suite 103 Wahiawa, HI - 967861841 |
| Business Phone Number: | 8086217733 |
| Business Fax Number: | 8086217799 |
| Mailing Address: | 302 California Ave, Suite 103 WAHIAWA |
| State: | HI |
| Postal Code: | 967861841 |
| Phone Number: | 8086217733 |
| Fax Number: | 8086217799 |
| NPI Enumeration Date: | 08/22/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | MD11212 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | HI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |