Provider Demographics
NPI:1093383986
Name:LAM, TRAN CHAU NGOC (PHARM D)
Entity Type:Individual
Prefix:
First Name:TRAN CHAU
Middle Name:NGOC
Last Name:LAM
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:PEARL
Other - Middle Name:
Other - Last Name:LAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:12234 PALMDALE RD
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392-9418
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12234 PALMDALE RD
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-9418
Practice Address - Country:US
Practice Address - Phone:760-493-3279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81268183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist