Provider Demographics
NPI:1548248628
Name:LAM, ALAN STEPHEN (MD)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:STEPHEN
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 1:7821 LINDA VISTA RD
Mailing Address - Street 2:APT 36
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-5116
Mailing Address - Country:US
Mailing Address - Phone:858-577-9900
Mailing Address - Fax:858-577-7985
Practice Address - Street 1:19871 BAUER RD
Practice Address - Street 2:BRANCH MEDICAL CLINIC, MARINE CORPS AIR STATION MIRAMAR
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92145-2002
Practice Address - Country:US
Practice Address - Phone:858-577-9900
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101237179208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice