Healthcare Provider Details

I. General information

NPI: 1508283839
Provider Name (Legal Business Name): FELICIA LAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2014
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33255 9TH ST
UNION CITY CA
94587-2137
US

IV. Provider business mailing address

33255 9TH ST
UNION CITY CA
94587-2137
US

V. Phone/Fax

Practice location:
  • Phone: 510-471-5880
  • Fax:
Mailing address:
  • Phone: 510-471-5880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA149841
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: