Provider Demographics
NPI:1356800254
Name:LAM, TINA YAQING CAI (MD)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:YAQING CAI
Last Name:LAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:YAQING
Other - Middle Name:
Other - Last Name:CAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3505 BROADWAY FL 4
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5798
Mailing Address - Country:US
Mailing Address - Phone:510-752-1075
Mailing Address - Fax:
Practice Address - Street 1:3505 BROADWAY FL 4
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5798
Practice Address - Country:US
Practice Address - Phone:510-752-1075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1963472084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty