Healthcare Provider Details

I. General information

NPI: 1487996492
Provider Name (Legal Business Name): MONICA LAU KATAMURA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MONICA P LAU MD

II. Dates (important events)

Enumeration Date: 03/18/2013
Last Update Date: 06/20/2022
Certification Date: 06/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 VALLEY CHILDRENS PL # 01
MADERA CA
93636-8761
US

IV. Provider business mailing address

9300 VALLEY CHILDRENS PL
MADERA CA
93636-8761
US

V. Phone/Fax

Practice location:
  • Phone: 559-353-6425
  • Fax: 559-353-6441
Mailing address:
  • Phone: 593-536-4255
  • Fax: 559-353-6441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number284726
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number284726
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC176845
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code207RA0000X
TaxonomyAdolescent Medicine (Internal Medicine) Physician
License NumberC176845
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: