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General NPI Number Information
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NPI Number | 1497721427
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Entity Type | Individual
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Provider Name | DANITA LAI O.D.
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Gender | Female
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Dates
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Enumeration Date | 02/28/2006
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Last Update Date | 01/03/2020
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Provider Practice Location Address
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Address Line | 28222 AGOURA RD STE 400
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City | AGOURA HILLS
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State | CA
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Zip | 91301-2411
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Country | US
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Telephone | 818-597-0070
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Fax | 818-597-0278
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Provider Business Mailing Address
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Address Line | 28222 AGOURA RD STE 400
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City | AGOURA HILLS
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State | CA
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Zip | 91301-2411
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Country | US
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Telephone | 818-597-0070
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Fax | 818-597-0278
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 8019TLG
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | 8019 TPL
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License Number State | CA
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