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General NPI Number Information
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NPI Number | 1568613990
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Entity Type | Individual
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Provider Name | IVAN GENE-KEE LAU RPH
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Gender | Male
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Dates
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Enumeration Date | 10/03/2008
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Last Update Date | 12/30/2013
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Provider Practice Location Address
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Address Line | 9201 W THOMAS RD
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City | PHOENIX
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State | AZ
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Zip | 85037-3332
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Country | US
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Telephone | 623-327-6170
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Fax | 623-327-6171
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Provider Business Mailing Address
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Address Line | 9201 W THOMAS RD
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City | PHOENIX
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State | AZ
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Zip | 85037-3332
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Country | US
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Telephone | 623-327-6170
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Fax | 623-327-6171
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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 | 14019
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 16263
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 45295
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License Number State | NY
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