=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750763439
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ISABELLA LAI M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/18/2015
-----------------------------------------------------
Last Update Date | 03/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10780 SANTA MONICA BLVD STE 350
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90025-4779
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 424-274-1550
-----------------------------------------------------
Fax | 920-352-4156
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10780 SANTA MONICA BLVD STE 350
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90025-4779
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 424-274-1550
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QR0404X
-----------------------------------------------------
Taxonomy Name | Cardiac Rehabilitation Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | A149405
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------