Active NPI
Man-Wa Lam, O.D.
- Optometrist
- Fremont, CA
National Provider Identifier
1043239742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 9783 T
- Practice address
- 34420 Fremont Blvd
Suite # E
Fremont, CA 94555-3323 - Phone
- (510) 796-9600
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 9783 T | CA | Primary |
Addresses
Primary practice location
34420 Fremont Blvd
Suite # E
Fremont, CA 94555-3323
Mailing address
4313 Delores Dr
Union City, CA 94587-4813
Phone (510) 675-9978
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9783 T | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234310400000",
"number": "1043239742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4313 DELORES DR",
"city": "UNION CITY",
"state": "CA",
"postal_code": "945874813",
"telephone_number": "510-675-9978",
"fax_number": "510-675-9978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34420 FREMONT BLVD",
"address_2": "SUITE # E",
"city": "FREMONT",
"state": "CA",
"postal_code": "945553323",
"telephone_number": "510-796-9600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAM",
"first_name": "MAN-WA",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2009-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "9783 T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.