Healthcare Provider Details

I. General information

NPI: 1659344943
Provider Name (Legal Business Name): YIN HSIUNG LAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 08/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 E FOOTHILL BLVD SUITE 203
UPLAND CA
91786-4070
US

IV. Provider business mailing address

1060 E FOOTHILL BLVD SUITE 203
UPLAND CA
91786-4070
US

V. Phone/Fax

Practice location:
  • Phone: 909-985-0699
  • Fax: 909-985-2399
Mailing address:
  • Phone: 909-985-0699
  • Fax: 909-985-8111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA36531
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: