Healthcare Provider Details

I. General information

NPI: 1760429393
Provider Name (Legal Business Name): ERIC C LAI D.C. / L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 12/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1017 S FAIR OAKS AVE
PASADENA CA
91105-2621
US

IV. Provider business mailing address

1017 S FAIR OAKS AVE
PASADENA CA
91105-2621
US

V. Phone/Fax

Practice location:
  • Phone: 626-403-6200
  • Fax: 626-403-2580
Mailing address:
  • Phone: 626-403-6200
  • Fax: 626-403-2580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC5654
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC 30069
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: