Provider Demographics
NPI:1811307176
Name:YAOHAN LAM DERMATOLOGY PLLC
Entity type:Organization
Organization Name:YAOHAN LAM DERMATOLOGY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YAOHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-361-8806
Mailing Address - Street 1:926 SW 107TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-5244
Mailing Address - Country:US
Mailing Address - Phone:405-735-9788
Mailing Address - Fax:405-735-9882
Practice Address - Street 1:926 SW 107TH ST STE 100
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-5244
Practice Address - Country:US
Practice Address - Phone:405-735-9788
Practice Address - Fax:405-735-9882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-07
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK27838207N00000X
261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty