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General NPI Number Information
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NPI Number | 1144951625
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Entity Type | Organization
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Legal Business Name | CHUN C LAI
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Dates
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Enumeration Date | 06/23/2022
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Last Update Date | 06/23/2022
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Provider Practice Location Address
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Address Line | 1612 1ST ST
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City | COACHELLA
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State | CA
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Zip | 92236-1407
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Country | US
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Telephone | 760-398-9000
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Fax | 760-398-9790
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Provider Business Mailing Address
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Address Line | 44120 MOJAVE CT
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City | INDIAN WELLS
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State | CA
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Zip | 92210-7203
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Country | US
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Telephone | 626-232-8315
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Fax | 505-485-0619
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Authorized Official
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Title or Position | CONSULTANT
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Name | DR. CHUN C LAI
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Credential | MD, MHA
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Telephone | 626-232-8315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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