Healthcare Provider Details

I. General information

NPI: 1154385961
Provider Name (Legal Business Name): ALBERT LAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 07/01/2021
Certification Date: 07/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1041 E YORBA LINDA BLVD STE 210
PLACENTIA CA
92870-3763
US

IV. Provider business mailing address

1041 E YORBA LINDA BLVD STE 210
PLACENTIA CA
92870-3763
US

V. Phone/Fax

Practice location:
  • Phone: 714-223-7000
  • Fax: 714-223-7001
Mailing address:
  • Phone: 714-223-7000
  • Fax: 714-223-7001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberA86192
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: