Individual
AMANDA SOPHIE LAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
160 DIAMOND DR, LAKE ELSINORE, CA 92530-4401
(951) 674-3562
Mailing address
29465 MAJOR LEAGUE, LAKE ELSINORE, CA 92530-4338
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
75315
CA
Other
Enumeration date
10/04/2016
Last updated
10/04/2016
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