Healthcare Provider Details

I. General information

NPI: 1003329137
Provider Name (Legal Business Name): TRACY LAM-LUU DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TRACY LAM DC

II. Dates (important events)

Enumeration Date: 11/11/2017
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1076 E 1ST ST STE A
TUSTIN CA
92780-3852
US

IV. Provider business mailing address

1076 E 1ST ST STE A
TUSTIN CA
92780-3852
US

V. Phone/Fax

Practice location:
  • Phone: 323-905-0899
  • Fax:
Mailing address:
  • Phone: 323-905-0899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number34065
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: