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General NPI Number Information
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NPI Number | 1326259490
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Entity Type | Individual
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Provider Name | MARY S LAM PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 01/25/2012
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Provider Practice Location Address
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Address Line | 30192 TOWN CENTER DR
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-2037
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Country | US
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Telephone | 949-495-8414
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 53992
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City | IRVINE
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State | CA
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Zip | 92619-3992
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Country | US
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Telephone | 949-322-0856
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 58432
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License Number State | CA
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