Healthcare Provider Details

I. General information

NPI: 1720919921
Provider Name (Legal Business Name): ANDREW HIEUANH LAM DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7325 DAY CREEK BLVD # B108
RANCHO CUCAMONGA CA
91739-8017
US

IV. Provider business mailing address

7325 DAY CREEK BLVD # B108
RANCHO CUCAMONGA CA
91739-8017
US

V. Phone/Fax

Practice location:
  • Phone: 909-326-2613
  • Fax:
Mailing address:
  • Phone: 408-717-2102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC37082
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: