Healthcare Provider Details

I. General information

NPI: 1598304560
Provider Name (Legal Business Name): VINCENT W KAM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2019
Last Update Date: 10/27/2026
Certification Date: 10/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 ARMY PENTAGON
WASHINGTON DC
20310-5801
US

IV. Provider business mailing address

PO BOX 4964
WOODBRIDGE VA
22194-4964
US

V. Phone/Fax

Practice location:
  • Phone: 703-692-8810
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0121000893
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: