Individual provider Active NPI

Paul K. Lam

  • Nursing Home Administrator
  • Brentwood, CA
National Provider Identifier
1508742362
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Home AdministratorTaxonomy code 376G00000X
License
079200739 Issued in CA
Practice address
2181 Wayne Dr
Brentwood, CA 94513-2359
Phone
(510) 759-8889
NPI assigned
Aug 15, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Home AdministratorGroup: 193200000X MULTI-SPECIALTY GROUP 376G00000X 079200739 CA Primary

Addresses

Primary practice location

2181 Wayne Dr
Brentwood, CA 94513-2359

Mailing address

2181 Wayne Dr
Brentwood, CA 94513-2359
Phone (510) 759-8889

Other practice location 1

2024 Sage Sparrow St
Brentwood, CA 94513-1777
Phone (510) 759-8889

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

LicenseStateTypeSpecialty
079200739CAMDNursing Home Administrator

NPI Registry JSON

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

{
    "created_epoch": "1755216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1508742362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2181 WAYNE DR",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945132359",
            "telephone_number": "510-759-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2181 WAYNE DR",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945132359",
            "telephone_number": "510-759-8889"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2024 Sage Sparrow St",
            "address_purpose": "LOCATION",
            "city": "Brentwood",
            "state": "CA",
            "postal_code": "945131777",
            "country_code": "US",
            "telephone_number": "510-759-8889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAM",
        "first_name": "PAUL",
        "middle_name": "K.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-15",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nursing Home Administrator",
            "state": "CA",
            "license": "079200739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.