Provider Demographics
NPI:1710452081
Name:LAM, HOWARD MINH-LUAN
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:MINH-LUAN
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 1:2966 MOUNT CLARE DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-2067
Mailing Address - Country:US
Mailing Address - Phone:408-531-7157
Mailing Address - Fax:
Practice Address - Street 1:1376 KOOSER RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95118-3813
Practice Address - Country:US
Practice Address - Phone:408-448-2503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79480183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist