Provider Demographics
NPI:1851601074
Name:LAM, RANDY SF (ACUPUNTURIST)
Entity Type:Individual
Prefix:MR
First Name:RANDY
Middle Name:SF
Last Name:LAM
Suffix:
Gender:M
Credentials:ACUPUNTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 COOLIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-2765
Mailing Address - Country:US
Mailing Address - Phone:510-533-3989
Mailing Address - Fax:510-536-6808
Practice Address - Street 1:3100 COOLIDGE AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-2765
Practice Address - Country:US
Practice Address - Phone:510-533-3989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALHC5564171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist