Provider Demographics
NPI:1265493563
Name:LAM, KITTY (MD)
Entity Type:Individual
Prefix:
First Name:KITTY
Middle Name:
Last Name:LAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 W COLLEGE STREET
Mailing Address - Street 2:#210
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012
Mailing Address - Country:US
Mailing Address - Phone:626-284-6608
Mailing Address - Fax:213-625-1245
Practice Address - Street 1:711 W COLLEGE STREET
Practice Address - Street 2:#210
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012
Practice Address - Country:US
Practice Address - Phone:626-284-6608
Practice Address - Fax:213-625-1245
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG40296207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
G40296Medicare ID - Type Unspecified
A92175Medicare UPIN