Doctor Name: | GIA THANH LAM |
NPI Number: | 1437346814 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | A39556 |
Business Practice Address: | 5th & Western St California Rehabilitation Center Crc Norco, CA - 928600991 |
Business Phone Number: | 9517372683 |
Business Fax Number: | 9512732318 |
Mailing Address: | Po Box 1841, California Rehabilitation Center Crc NORCO |
State: | CA |
Postal Code: | 928600991 |
Phone Number: | 9517372683 |
Fax Number: | 9512732318 |
NPI Enumeration Date: | 09/28/2007 |
NPI Last Update Date: | 09/28/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A39556 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |