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General NPI Number Information
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NPI Number | 1134091200
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Entity Type | Individual
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Provider Name | KATHERINE BAO LAM
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Gender | Female
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Dates
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Enumeration Date | 09/19/2025
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 200 W CENTER STREET PROMENADE
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City | ANAHEIM
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State | CA
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Zip | 92805-3960
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Country | US
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Telephone | 714-618-9582
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Fax |
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Provider Business Mailing Address
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Address Line | 1725 S AUBURN WAY UNIT 206
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City | ANAHEIM
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State | CA
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Zip | 92805-6610
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Country | US
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Telephone | 925-858-4431
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 91445
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License Number State | CA
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