Provider Demographics
NPI:1760252712
Name:LAM YUEN, GOODMAN
Entity Type:Individual
Prefix:
First Name:GOODMAN
Middle Name:
Last Name:LAM YUEN
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 1:955 W CRAIG RD STE 114
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-0284
Mailing Address - Country:US
Mailing Address - Phone:702-874-4848
Mailing Address - Fax:
Practice Address - Street 1:955 W CRAIG RD STE 114
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-0284
Practice Address - Country:US
Practice Address - Phone:702-874-4848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide