Individual
AIDAN LAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
165 W HOSPITALITY LN STE 27, SAN BERNARDINO, CA 92408-3326
(442) 327-9172
Mailing address
21055 BENIK PL, WALNUT, CA 91789-2001
(909) 551-6399
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/16/2024
Last updated
08/16/2024
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