Individual
MAIANH DAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25455 BARTON RD STE 204B, LOMA LINDA, CA 92354-3130
(909) 558-6600
Mailing address
FILE # 54701, LOS ANGELES, CA 90074-4701
(909) 651-4300
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
A181397
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2019
Last updated
07/26/2023
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