Provider Demographics
NPI:1770346371
Name:LAM, JASON (PA-C)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:LAM
Suffix:
Gender:M
Credentials:PA-C
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Other - Middle Name:
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Mailing Address - Street 1:616 N GARFIELD AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1153
Mailing Address - Country:US
Mailing Address - Phone:626-635-1688
Mailing Address - Fax:
Practice Address - Street 1:616 N GARFIELD AVE STE 203
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1153
Practice Address - Country:US
Practice Address - Phone:626-635-1688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant