Healthcare Provider Details

I. General information

NPI: 1174836217
Provider Name (Legal Business Name): JOY LAM O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2010
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 UNIVERSITY AVE
PALO ALTO CA
94301-1812
US

IV. Provider business mailing address

6174 CECALA DR
SAN JOSE CA
95120-2709
US

V. Phone/Fax

Practice location:
  • Phone: 650-327-2020
  • Fax: 650-327-2039
Mailing address:
  • Phone: 832-423-9859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number14365
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number7604T
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number14365 TLG
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: