Healthcare Provider Details

I. General information

NPI: 1538785951
Provider Name (Legal Business Name): CAROLINE G.Y. LAU, MD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2020
Last Update Date: 07/08/2020
Certification Date: 07/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 PUNAHOU ST STE 525
HONOLULU HI
96826-1073
US

IV. Provider business mailing address

1319 PUNAHOU ST STE 525
HONOLULU HI
96826-1073
US

V. Phone/Fax

Practice location:
  • Phone: 808-947-3122
  • Fax: 808-791-5021
Mailing address:
  • Phone: 808-947-3122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: CAROLINE LAU
Title or Position: OWNER
Credential: MD
Phone: 808-398-8767