Ilana Wong Lam, PT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT25469 Issued in CA

Practice address

20823 Stevens Creek Blvd
Suite #200
Cupertino, CA 95014-2108

Phone

(408) 252-6076

Fax

(408) 252-1159

NPI assigned

Feb 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ilana Jacinthe Wong Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669515748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20823 STEVENS CREEK BLVD",
            "address_2": "SUITE #200",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950142108",
            "telephone_number": "408-252-6076",
            "fax_number": "408-252-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20823 STEVENS CREEK BLVD",
            "address_2": "SUITE #200",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950142108",
            "telephone_number": "408-252-6076",
            "fax_number": "408-252-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "ILANA",
        "middle_name": "WONG",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT25469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ILANA",
            "last_name": "WONG",
            "middle_name": "JACINTHE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Orthopedic Physical Therapist in Cupertino, CA
• Providers in Cupertino, CA by specialty
• Orthopedic Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.