Provider Demographics
NPI:1154376408
Name:NGUYEN, LAM (DC)
Entity type:Individual
Prefix:
First Name:LAM
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3139 CENTERWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-2658
Mailing Address - Country:US
Mailing Address - Phone:408-386-6679
Mailing Address - Fax:408-254-3176
Practice Address - Street 1:1610 MCKEE RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1259
Practice Address - Country:US
Practice Address - Phone:408-386-6670
Practice Address - Fax:408-254-3176
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29990111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor