Healthcare Provider Details

I. General information

NPI: 1124415617
Provider Name (Legal Business Name): MICHAEL LAU CHIROPRACTIC, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2015
Last Update Date: 05/19/2025
Certification Date: 05/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28382 S WESTERN AVE
RANCHO PALOS VERDES CA
90275-1434
US

IV. Provider business mailing address

PO BOX 13692
TORRANCE CA
90503-0692
US

V. Phone/Fax

Practice location:
  • Phone: 310-328-1950
  • Fax:
Mailing address:
  • Phone: 310-328-1950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC25157
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number134396
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number3371
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC10112
License Number StateCA

VIII. Authorized Official

Name: DR. MICHAEL LAU
Title or Position: PRESIDENT
Credential: D.C.
Phone: 310-328-1950