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General NPI Number Information
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NPI Number | 1053741280
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Entity Type | Organization
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Legal Business Name | ELSON LAI, MD, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 11/25/2013
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Last Update Date | 11/25/2013
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Provider Practice Location Address
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Address Line | 9428 VALLEY BLVD STE 201
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City | ROSEMEAD
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State | CA
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Zip | 91770-1514
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Country | US
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Telephone | 626-353-0399
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Fax |
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Provider Business Mailing Address
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Address Line | 9428 VALLEY BLVD STE 201
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City | ROSEMEAD
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State | CA
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Zip | 91770-1514
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Country | US
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Telephone | 626-353-0399
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELSON LAI
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Credential | MD
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Telephone | 626-353-0399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number | A116241
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License Number State | CA
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