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General NPI Number Information
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NPI Number | 1235332297
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Entity Type | Organization
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Legal Business Name | GILBERT LAY DDS
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 10/12/2015
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Provider Practice Location Address
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Address Line | 13922 IMPERIAL HWY
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City | LA MIRADA
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State | CA
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Zip | 90638
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Country | US
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Telephone | 502-926-7025
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Fax | 502-926-0956
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Provider Business Mailing Address
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Address Line | 12319 IMPERIAL HWY
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City | NORWALK
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State | CA
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Zip | 90650-8303
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Country | US
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Telephone | 562-868-7955
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Fax | 562-929-8052
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Authorized Official
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Title or Position | OWNER
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Name | GILBERT KHIN LAY
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Credential | DDS
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Telephone | 562-505-7002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 40648
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License Number State | CA
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