Provider Demographics
NPI:1639546054
Name:LAM, HAI (FNP-C)
Entity Type:Individual
Prefix:
First Name:HAI
Middle Name:
Last Name:LAM
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4529 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105-3528
Mailing Address - Country:US
Mailing Address - Phone:619-817-1603
Mailing Address - Fax:
Practice Address - Street 1:102 MILE OF CARS WAY
Practice Address - Street 2:U.S. HEALTHWORKS MEDICAL GROUP (MULTIPLE LOCATION)
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-6603
Practice Address - Country:US
Practice Address - Phone:619-474-9211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-02
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95003301363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily