Provider Demographics
NPI:1598355943
Name:LAM, KIMBERLY TRAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:TRAN
Last Name:LAM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1553 CERRO DE ORO
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-3600
Mailing Address - Country:US
Mailing Address - Phone:760-672-5335
Mailing Address - Fax:
Practice Address - Street 1:320 S TWIN OAKS VALLEY RD
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-4333
Practice Address - Country:US
Practice Address - Phone:760-471-8019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83526183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist