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General NPI Number Information
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NPI Number | 1407334667
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Entity Type | Individual
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Provider Name | TIFFANY LAI
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Gender | Female
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Dates
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Enumeration Date | 07/31/2018
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Last Update Date | 07/31/2018
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Provider Practice Location Address
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Address Line | 3208 E FLORENCE AVE
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-5832
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Country | US
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Telephone | 323-589-1916
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Fax |
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Provider Business Mailing Address
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Address Line | 4910 WHITE CT
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City | TORRANCE
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State | CA
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Zip | 90503-2245
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Country | US
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Telephone | 310-561-9625
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 76740
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License Number State | CA
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