Healthcare Provider Details

I. General information

NPI: 1346669207
Provider Name (Legal Business Name): SAMANTHA LAU CHEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SAMANTHA FONG-TING LAU MD

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 THE CITY DR S
ORANGE CA
92868-3201
US

IV. Provider business mailing address

PO BOX 3589
NEWPORT BEACH CA
92659-8589
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-5726
  • Fax:
Mailing address:
  • Phone: 657-241-3600
  • Fax: 657-241-7708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA142174
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberA142174
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number288718
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberA142174
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: