Individual
PHUONG TU LAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17100 EUCLID ST, FOUNTAIN VALLEY, CA 92708-4004
(714) 513-5521
Mailing address
8672 LARIAT AVE, GARDEN GROVE, CA 92844-2509
(714) 726-2213
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
845294
CA
Other
Enumeration date
06/13/2018
Last updated
06/13/2018
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