Provider Demographics
NPI:1700971769
Name:JAMM, LILY ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:LILY
Middle Name:ELIZABETH
Last Name:JAMM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1158 N COURT ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-0436
Mailing Address - Country:US
Mailing Address - Phone:530-247-7234
Mailing Address - Fax:530-247-7228
Practice Address - Street 1:1158 N COURT ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-0436
Practice Address - Country:US
Practice Address - Phone:530-247-7234
Practice Address - Fax:530-247-7228
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64590207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A64590Medicare ID - Type Unspecified