Individual provider Active NPI

Vinh Thuy Lam, M.D.

  • Pediatric Surgery Physician
  • Orange, CA
National Provider Identifier
1336119122
Registry record updated Mar 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
G80725 Issued in CA
Practice address
396 S Main St Ste 200
Orange, CA 92868-3845
Phone
(714) 361-4480
Fax
(714) 361-4490
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X G80725 CA Primary

Addresses

Primary practice location

396 S Main St Ste 200
Orange, CA 92868-3845

Mailing address

396 S Main St Ste 200
Orange, CA 92868-3845
Phone (714) 361-4480

Other identifiers 1

IdentifierTypeStateIssuer
00G807250MedicaidCA

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
I20080522000735 CA Practitioner - Other (Physician)Practitioner - General SurgeryPractitioner - Pediatric Medicine 7214006865 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G80725CAMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Surgical Associates Inc a Medical Corporation CurrentSince Oct 19, 2016 Accepting new patients
St Joseph Hospital of Orange Past Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients
St. Mary Medical Center Past Accepting new patients
Saddleback Memorial Medical Center Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Long Beach Memorial Medical Past Accepting new patients
Pediatric Subspecialty Faculty, Inc. Past Accepting new patients
Dignity Health Past Accepting new patients
University of California Irvine Past Accepting new patients

Locations

9400 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-6064

26730 Crown Valley Pkwy
Mission Viejo, CA 92691
Phone (949) 364-2201

26691 Plaza
Ste 130
Mission Viejo, CA 92691
Phone (888) 770-2462

27401 Los Altos
Ste 180
Mission Viejo, CA 92691
Phone (949) 582-9624

1120 W La Veta Ave
Ste 100
Orange, CA 92868
Phone (714) 289-4704

396 S Main St
Ste 200
Orange, CA 92868
Phone (714) 361-4480

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 11

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1336119122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 S MAIN ST STE 200",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683845",
            "telephone_number": "714-361-4480",
            "fax_number": "714-361-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 S MAIN ST STE 200",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683845",
            "telephone_number": "714-361-4480",
            "fax_number": "714-361-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "VINH",
        "middle_name": "THUY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "CA",
            "license": "G80725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G807250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.