Provider Demographics
NPI:1548433519
Name:LAM, ANDREW T (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:T
Last Name:LAM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10644 ZELZAH AVE
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-5903
Mailing Address - Country:US
Mailing Address - Phone:818-368-8999
Mailing Address - Fax:818-368-8558
Practice Address - Street 1:10644 ZELZAH AVE
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-5903
Practice Address - Country:US
Practice Address - Phone:818-368-8999
Practice Address - Fax:818-368-8558
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29133111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor