Provider Demographics
NPI:1821209057
Name:LAM, THUY CAM-THI (OD)
Entity Type:Individual
Prefix:DR
First Name:THUY
Middle Name:CAM-THI
Last Name:LAM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 W 3RD ST APT 2
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731-6208
Mailing Address - Country:US
Mailing Address - Phone:310-832-4876
Mailing Address - Fax:
Practice Address - Street 1:3535 S LA CIENEGA BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90016-4407
Practice Address - Country:US
Practice Address - Phone:310-202-1050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11684T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist