Provider Demographics
NPI:1619021052
Name:LAM, DANNY C
Entity Type:Individual
Prefix:
First Name:DANNY
Middle Name:C
Last Name:LAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24122 CINDY LN
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-1813
Mailing Address - Country:US
Mailing Address - Phone:949-770-9025
Mailing Address - Fax:
Practice Address - Street 1:26691 PLAZA DRIVE
Practice Address - Street 2:SUITE 205
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691
Practice Address - Country:US
Practice Address - Phone:949-367-1088
Practice Address - Fax:949-367-1042
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT33319225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist