1841292422 NPI number — CARDIO MUNICIPAL

Table of content: PHILLIP HONG LAM M.D. (NPI 1881984110)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841292422 NPI number — CARDIO MUNICIPAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARDIO MUNICIPAL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841292422
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/05/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 70344
Provider Second Line Business Mailing Address:
PMB #68
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00936-8344
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-756-7796
Provider Business Mailing Address Fax Number:
787-756-7796

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SAN JUAN CITY HOSPITAL
Provider Second Line Business Practice Location Address:
CARDIOLOGY SECTION - ROOM 330
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-756-7796
Provider Business Practice Location Address Fax Number:
787-756-7796
Provider Enumeration Date:
08/12/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ARIZA
Authorized Official First Name:
EDDY
Authorized Official Middle Name:
MIESES
Authorized Official Title or Position:
DIRECTOR OF GROUP
Authorized Official Telephone Number:
787-756-7796

Provider Taxonomy Codes

  • Taxonomy code: 261QP0905X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)