Active NPI
Phuc Thoai Lam, MD
- Geriatric Medicine (Family Medicine) Physician
- Garden Grove, CA
National Provider Identifier
1518930197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Family Medicine) Physician
- License
- A 88219
- Practice address
- 10872 Westminster Ave
Suite 114
Garden Grove, CA 92843-4981 - Phone
- (714) 209-8319
- Fax
- (714) 530-2365
- NPI assigned
- Feb 13, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | A 88219 | CA | Primary |
Addresses
Primary practice location
10872 Westminster Ave
Suite 114
Garden Grove, CA 92843-4981
Mailing address
467 Arcadia Way
Salinas, CA 93906-2178
Phone (714) 209-8319
Other names 1
- Dr. Peter Thoai Lam
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A 88219 | CA | MD | Geriatric Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peter Lam Thoai Phuc, MD, Inc. | Geriatric Medicine | Past | Accepting new patients |
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.
-
dba Greater Pomona Medical & Rehab Center
- Physical Therapist
- Pomona, CA
- NPI 1376571216
Geriatric Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248134400000",
"number": "1518930197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "467 ARCADIA WAY",
"city": "SALINAS",
"state": "CA",
"postal_code": "939062178",
"telephone_number": "714-209-8319",
"fax_number": "831-444-6447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10872 WESTMINSTER AVE",
"address_2": "SUITE 114",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928434981",
"telephone_number": "714-209-8319",
"fax_number": "714-530-2365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAM",
"first_name": "PHUC",
"middle_name": "THOAI",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-13",
"last_updated": "2009-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207QG0300X",
"taxonomy_group": "",
"desc": "Family Medicine, Geriatric Medicine",
"state": "CA",
"license": "A 88219",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "PETER",
"last_name": "LAM",
"middle_name": "THOAI",
"prefix": "DR.",
"credential": "MD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.