Individual provider Active NPI

Kathleen Lam

  • Physical Therapist
  • Diamond Bar, CA
National Provider Identifier
1174313522
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
307974 Issued in CA
Practice address
21015 Pathfinder Rd
Diamond Bar, CA 91765-4018
Phone
(909) 861-3511
NPI assigned
May 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 307974 CA Primary

Addresses

Primary practice location

21015 Pathfinder Rd
Diamond Bar, CA 91765-4018

Mailing address

7871 Orchid Dr
Eastvale, CA 92880-3530
Phone (909) 816-3222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250620002340 CA Practitioner - Physical Therapist in Private Practice 0042722522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pomona Valley Orthopedic and Sports Physical Therapy IncGroup PAC ID 4284536814, 15 clinicians

Practice addresses (Care Compare)

21015 Pathfinder Rd
Suite 100
Diamond Bar, CA 91765-4002
Phone (909) 861-3511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pomona Valley Orthopedic and Sports Physical Therapy, Inc Physical Therapist CurrentSince May 12, 2025 Accepting new patients

Locations

21015 Pathfinder Rd
Ste 100
Diamond Bar, CA 91765
Phone 9098613511 ext. 305

Organizations & group practices 1

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": "1746662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1174313522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7871 ORCHID DR",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928803530",
            "telephone_number": "909-816-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21015 PATHFINDER RD",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917654018",
            "telephone_number": "909-861-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-08",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "307974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamond Bar, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.