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General NPI Number Information
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NPI Number | 1205497104
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Entity Type | Individual
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Provider Name | ALEXANDER LAM MD
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Gender | Male
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Dates
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Enumeration Date | 06/23/2019
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 350 VINTON AVE STE 202
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City | POMONA
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State | CA
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Zip | 91767-3000
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Country | US
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Telephone | 909-973-1148
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Fax | 909-363-4954
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Provider Business Mailing Address
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Address Line | 5501 OLD YORK RD
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City | PHILADELPHIA
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State | PA
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Zip | 19141-3018
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Country | US
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Telephone |
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | MT218054
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License Number State | PA
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