Provider Demographics
NPI:1629139746
Name:LAM, TRUNG CHANH (PHARM D)
Entity Type:Individual
Prefix:
First Name:TRUNG
Middle Name:CHANH
Last Name:LAM
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5350 TOSCANA WAY
Mailing Address - Street 2:APT E107
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-5672
Mailing Address - Country:US
Mailing Address - Phone:626-757-1462
Mailing Address - Fax:
Practice Address - Street 1:5350 TOSCANA WAY
Practice Address - Street 2:APT E107
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-5672
Practice Address - Country:US
Practice Address - Phone:626-757-1462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57245183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist