Individual provider Active NPI

Gary Man Lam, MD

  • Orthopaedic Surgery of the Spine Physician
  • Redding, CA
National Provider Identifier
1083625701
Registry record updated Sep 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
G84812 Issued in CA
Practice address
2510 Airpark Dr 106
Redding, CA 96001-2461
Phone
(530) 241-9800
Fax
(530) 241-9808
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X G84812 CA Primary

Addresses

Primary practice location

2510 Airpark Dr 106
Redding, CA 96001-2461

Mailing address

PO Box 496084
Redding, CA 96049-6084
Phone (530) 241-9800

Other identifiers 1

IdentifierTypeStateIssuer
200368580MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070612000456 CA Practitioner - Orthopedic Surgery 2264530443 Practice locations: Redding, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G84812CAMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marta E Alvarez MD PC PastSince Nov 6, 2017 Accepting new patients
Timothy a Fitzer MD Inc a Professional Medical Corporation Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442188800000",
    "number": "1083625701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 496084",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960496084",
            "telephone_number": "530-241-9800",
            "fax_number": "530-241-9808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 AIRPARK DR 106",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012461",
            "telephone_number": "530-241-9800",
            "fax_number": "530-241-9808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "GARY",
        "middle_name": "MAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2015-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "G84812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200368580",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.