Provider Demographics
NPI:1841374642
Name:LAMB, CAROLYN E (MD,)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:E
Last Name:LAMB
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 BEVERLY WAY
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-2516
Mailing Address - Country:US
Mailing Address - Phone:626-799-4151
Mailing Address - Fax:626-799-4207
Practice Address - Street 1:2050 HUNTINGTON DR
Practice Address - Street 2:SUITE D
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-4900
Practice Address - Country:US
Practice Address - Phone:626-799-4151
Practice Address - Fax:626-799-4207
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG63459207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF51339Medicare UPIN
CAHG63459Medicare ID - Type Unspecified
CAHG63459Medicare PIN