Provider Demographics
NPI:1477095875
Name:LAM, DARREN WAI-YI (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DARREN
Middle Name:WAI-YI
Last Name:LAM
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:111 N SEPULVEDA BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-6861
Mailing Address - Country:US
Mailing Address - Phone:310-379-2134
Mailing Address - Fax:310-379-4856
Practice Address - Street 1:111 N SEPULVEDA BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-6861
Practice Address - Country:US
Practice Address - Phone:310-379-2134
Practice Address - Fax:310-379-4856
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-16
Last Update Date:2023-12-22
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Provider Licenses
StateLicense IDTaxonomies
CA53972363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant