Healthcare Provider Details

I. General information

NPI: 1760870067
Provider Name (Legal Business Name): LINDA LAM M.S., OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2015
Last Update Date: 01/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 NEVADA AVE
EL MONTE CA
91733-2318
US

IV. Provider business mailing address

2720 NEVADA AVE
EL MONTE CA
91733-2318
US

V. Phone/Fax

Practice location:
  • Phone: 626-443-9425
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number10772
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: