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General NPI Number Information
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NPI Number | 1457755209
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Entity Type | Organization
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Legal Business Name | GARY KWOK-YING LAM DPM A PROFESSIONAL CORP
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Dates
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Enumeration Date | 10/22/2014
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Last Update Date | 06/01/2015
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Provider Practice Location Address
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Address Line | 410 16TH AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-2812
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Country | US
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Telephone | 415-933-6725
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Fax | 415-933-6726
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Provider Business Mailing Address
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Address Line | 410 16TH AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-2812
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Country | US
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Telephone | 415-933-6725
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Fax | 415-933-6726
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Authorized Official
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Title or Position | CEO
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Name | DR. GARY K LAM
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Credential | D.P.M
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Telephone | 415-845-9383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E4748
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License Number State | CA
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