Provider Demographics
NPI:1619041019
Name:LAM, DONGTHU QUOC (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DONGTHU
Middle Name:QUOC
Last Name:LAM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:DAWN
Other - Middle Name:QUOC
Other - Last Name:LAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2113 WENDOVER LN
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95121-1465
Mailing Address - Country:US
Mailing Address - Phone:408-528-1643
Mailing Address - Fax:
Practice Address - Street 1:2113 WENDOVER LN
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95121-1465
Practice Address - Country:US
Practice Address - Phone:408-528-1643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53589183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist