Healthcare Provider Details

I. General information

NPI: 1588246482
Provider Name (Legal Business Name): GEORGE KAIBON LAU DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2021
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 34TH ST
BAKERSFIELD CA
93301-2237
US

IV. Provider business mailing address

12608 LOCKSLEY DR
BAKERSFIELD CA
93311-8559
US

V. Phone/Fax

Practice location:
  • Phone: 661-327-4647
  • Fax: 706-653-1162
Mailing address:
  • Phone: 347-570-6803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number20A24337
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number1025091
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: