Healthcare Provider Details

I. General information

NPI: 1407992001
Provider Name (Legal Business Name): JAMES EDWARD LAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 05/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 HAWTHORNE AVE STE 201
OAKLAND CA
94609-3114
US

IV. Provider business mailing address

365 HAWTHORNE AVE STE 201
OAKLAND CA
94609-3114
US

V. Phone/Fax

Practice location:
  • Phone: 510-452-1345
  • Fax:
Mailing address:
  • Phone:
  • Fax: 510-452-1102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberA137051
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: