MEDICARE: DR. PAUL PAO-CHIEN LAI D.O.

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	207Q00000X	Family Medicine Physician	20A7294	CA

General Provider Information

NPI Number	:	1508811514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL PAO-CHIEN LAI D.O.

Provider Business Mailing Address
First Line	:	5475 WALNUT AVE
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710-2609
Country	:	US
Telephone Number	:	909-591-6446
Fax Number	:	909-591-1309

Provider Business Practice Location Address
First Line	:	5475 WALNUT AVE
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710-2609
Country	:	US
Telephone Number	:	909-591-6446
Fax Number	:	909-591-1309

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	11/29/2021

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