Provider Demographics
NPI:1134707789
Name:LAM, NATALIE LAI KI (PHARM D)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:LAI KI
Last Name:LAM
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16507 DOVE CANYON RD APT 6108
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-4302
Mailing Address - Country:US
Mailing Address - Phone:858-663-8297
Mailing Address - Fax:
Practice Address - Street 1:44100 JEFFERSON ST STE F
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-2715
Practice Address - Country:US
Practice Address - Phone:760-895-6031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84104183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist