Healthcare Provider Details

I. General information

NPI: 1649397241
Provider Name (Legal Business Name): JENNIFER C LAI M.D., M.B.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 08/06/2023
Certification Date: 08/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 PARNASSUS AVE, 3RD FLOOR
SAN FRANCISCO CA
94117-3608
US

IV. Provider business mailing address

513 PARNASSUS AVE S-357
SAN FRANCISCO CA
94143-2205
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-2318
  • Fax: 415-353-2407
Mailing address:
  • Phone: 415-353-2318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA101839
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RT0003X
TaxonomyTransplant Hepatology Physician
License NumberA101839
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number243395
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: