Provider Demographics
NPI:1477713576
Name:LAM, VINCENT BASAN (MD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:BASAN
Last Name:LAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:VINCENT
Other - Middle Name:BASAN
Other - Last Name:LAM CHOI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1740 SOUTH ST STE 400
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1514
Mailing Address - Country:US
Mailing Address - Phone:267-607-6888
Mailing Address - Fax:267-393-4310
Practice Address - Street 1:1740 SOUTH ST STE 400
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1514
Practice Address - Country:US
Practice Address - Phone:267-607-6888
Practice Address - Fax:267-393-4310
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD440839207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology