Individual provider · Type 1 NPI

Tam Ly

Student in an Organized Health Care Education/Training Program · Gardena, CA

NPI number 1497061071 Active

Practice location

14112 S Kingsley Dr
Gardena, CA 90249-3018

Call (310) 217-7312 Map

Mailing address

15317 Santa Gertrudes Ave Unit JJ103
La Mirada, CA 90638-5088

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XD8892587 (CA)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1497061071

Tam Ly's National Provider Identifier is 1497061071, issued on Aug 20, 2010. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Gardena, CA. The record was last updated on Aug 20, 2010.