Active NPI
Jonathan Wei Lam
- Physical Therapy Assistant
- El Segundo, CA
National Provider Identifier
1396255253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 47911
- Practice address
- 390 N Sepulveda Blvd
El Segundo, CA 90245-4475 - Phone
- (310) 640-9911
- NPI assigned
- Oct 5, 2017
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 47911 | CA | Primary |
Addresses
Primary practice location
390 N Sepulveda Blvd
El Segundo, CA 90245-4475
Mailing address
21003 Amie Ave
37
Torrance, CA 90503-4744
Phone (424) 394-9728
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47911 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507161600000",
"number": "1396255253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21003 AMIE AVE",
"address_2": "37",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905034744",
"telephone_number": "424-394-9728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "390 N SEPULVEDA BLVD",
"city": "EL SEGUNDO",
"state": "CA",
"postal_code": "902454475",
"telephone_number": "310-640-9911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAM",
"first_name": "JONATHAN",
"middle_name": "WEI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-10-05",
"last_updated": "2017-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "47911",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Segundo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.