Healthcare Provider Details

I. General information

NPI: 1215390620
Provider Name (Legal Business Name): ADRIAN LAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 05/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

354 SANTA FE DR
ENCINITAS CA
92024-5142
US

IV. Provider business mailing address

402 DICKINSON ST SUITE 380
SAN DIEGO CA
92103-6902
US

V. Phone/Fax

Practice location:
  • Phone: 760-230-2551
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License NumberA151841
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: