MEDICARE: ALICE T LAU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RPH36979	CA
2	183500000X	Pharmacist	8619	NV

General Provider Information

NPI Number	:	1114204039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICE T LAU

Provider Business Mailing Address
First Line	:	459 POWELL ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-1503
Country	:	US
Telephone Number	:	415-984-0793
Fax Number	:	415-984-0796

Provider Business Practice Location Address
First Line	:	459 POWELL ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-1503
Country	:	US
Telephone Number	:	415-984-0793
Fax Number	:	415-984-0796

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2011
Last Update Date	:	11/06/2011

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Directions to “ ALICE T LAU ” Practice Location

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