MEDICARE: DR. CHING LAM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2081P0004X	Spinal Cord Injury Medicine Physician	226607	MA
2	208100000X	Physical Medicine & Rehabilitation Physician	226607	MA

General Provider Information

NPI Number	:	1255319893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHING LAM MD

Provider Business Mailing Address
First Line	:	13652 CANTARA ST
Second Line	:	OCCUPATIONAL MEDICINE
City	:	PANORAMA CITY
State	:	CA
Zip	:	91402-5423
Country	:	US
Telephone Number	:	818-375-2233
Fax Number	:	818-375-2535

Provider Business Practice Location Address
First Line	:	13652 CANTARA ST
Second Line	:	OCCUPATIONAL MEDICINE
City	:	PANORAMA CITY
State	:	CA
Zip	:	91402-5423
Country	:	US
Telephone Number	:	818-375-2233
Fax Number	:	818-375-2535

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	12/01/2021

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