Healthcare Provider Details

I. General information

NPI: 1144298431
Provider Name (Legal Business Name): GREGORY WEI-YIP LAU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: GREG LAU MD

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 12/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2851 S AVENUE B SUITE 2001, BLDG 20
YUMA AZ
85364-7726
US

IV. Provider business mailing address

2851 S AVENUE B BUILDING 20
YUMA AZ
85364-7726
US

V. Phone/Fax

Practice location:
  • Phone: 928-336-2434
  • Fax: 928-336-2435
Mailing address:
  • Phone: 928-336-2434
  • Fax: 928-336-2435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberB59255
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberC54388
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number43374
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberB59255
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: