Provider Demographics
NPI:1023662855
Name:LAM, SIMON TAT-SHING (RN)
Entity type:Individual
Prefix:MR
First Name:SIMON
Middle Name:TAT-SHING
Last Name:LAM
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 E. EMERSON AVENUE
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91755-1875
Mailing Address - Country:US
Mailing Address - Phone:626-278-9599
Mailing Address - Fax:626-288-7633
Practice Address - Street 1:222 E. EMERSON AVENUE
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91755-1875
Practice Address - Country:US
Practice Address - Phone:626-278-9599
Practice Address - Fax:626-288-7633
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-30
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN525875163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health