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General NPI Number Information
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NPI Number | 1669660734
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Entity Type | Organization
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Legal Business Name | LAM CLINIC, INC
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Dates
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Enumeration Date | 10/13/2007
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Last Update Date | 10/13/2007
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Provider Practice Location Address
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Address Line | 100 N BERETANIA ST STE 208
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City | HONOLULU
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State | HI
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Zip | 96817-4709
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Country | US
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Telephone | 808-536-6333
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Fax | 808-566-6080
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Provider Business Mailing Address
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Address Line | 100 N BERETANIA ST STE 208
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City | HONOLULU
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State | HI
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Zip | 96817-4709
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Country | US
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Telephone | 808-536-6333
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Fax | 808-566-6080
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FREDERICK M. K. LAM
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Credential | MD
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Telephone | 808-536-6333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 573
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License Number State | HI
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