Healthcare Provider Details

I. General information

NPI: 1154655090
Provider Name (Legal Business Name): ANGA LAO AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2009
Last Update Date: 05/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

490 POST ST STE 933
SAN FRANCISCO CA
94102-1414
US

IV. Provider business mailing address

490 POST ST STE 933
SAN FRANCISCO CA
94102-1414
US

V. Phone/Fax

Practice location:
  • Phone: 415-362-2901
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number2694
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: