Healthcare Provider Details

I. General information

NPI: 1285975045
Provider Name (Legal Business Name): JEFFREY M. LAU, M.D., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2013
Last Update Date: 03/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 LUSITANA ST SUITE 108
HONOLULU HI
96813-2429
US

IV. Provider business mailing address

1329 LUSITANA ST SUITE 108
HONOLULU HI
96813-2429
US

V. Phone/Fax

Practice location:
  • Phone: 808-537-1974
  • Fax: 808-537-1976
Mailing address:
  • Phone: 808-537-1974
  • Fax: 808-537-1976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberMD3795
License Number StateHI

VIII. Authorized Official

Name: DR. JEFFREY M. LAU LAU
Title or Position: OWNER
Credential: M.D.
Phone: 808-537-1974