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General NPI Number Information
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NPI Number | 1508583782
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Entity Type | Individual
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Provider Name | JONATHAN LAM PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/27/2022
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Last Update Date | 05/10/2024
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Provider Practice Location Address
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Address Line | 510 S VERMONT AVE FL 17
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City | LOS ANGELES
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State | CA
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Zip | 90020-1912
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Country | US
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Telephone | 503-220-8262
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Fax |
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Provider Business Mailing Address
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Address Line | 232 E 2ND ST STE A
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City | LOS ANGELES
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State | CA
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Zip | 90012-4541
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Country | US
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Telephone | 602-831-6119
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 88455
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License Number State | CA
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