MEDICARE: MARGARETTE LAO

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	65111	CA

General Provider Information

NPI Number	:	1134615370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARETTE LAO

Provider Business Mailing Address
First Line	:	15719 TETLEY ST APT 3G
Second Line	:
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-4549
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15719 TETLEY ST APT 3G
Second Line	:
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-4549
Country	:	US
Telephone Number	:	808-778-7174
Fax Number	:

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

Provider Enumeration Date	:	07/10/2018
Last Update Date	:	07/10/2018

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Directions to “ MARGARETTE LAO ” Practice Location

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