Provider Demographics
NPI:1811925258
Name:LAM, RICHARD Y (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:Y
Last Name:LAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4560 ADMIRALTY WAY STE 111
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-5424
Mailing Address - Country:US
Mailing Address - Phone:310-827-7707
Mailing Address - Fax:310-574-4002
Practice Address - Street 1:4560 ADMIRALTY WAY STE 111
Practice Address - Street 2:
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-5424
Practice Address - Country:US
Practice Address - Phone:310-827-7707
Practice Address - Fax:310-574-4002
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60442174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH43168Medicare UPIN