MEDICARE: DR. ALBERT LAI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist
2	208VP0000X	Pain Medicine Physician	A86192	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ZZZ28164Z	OTHER	CA	MEDICARE GROUP PTAN

General Provider Information

NPI Number	:	1154385961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALBERT LAI MD

Provider Business Mailing Address
First Line	:	1041 E YORBA LINDA BLVD
Second Line	:	STE 210
City	:	PLACENTIA
State	:	CA
Zip	:	92870-3763
Country	:	US
Telephone Number	:	714-223-7000
Fax Number	:	714-223-7001

Provider Business Practice Location Address
First Line	:	1041 E YORBA LINDA BLVD
Second Line	:	STE 210
City	:	PLACENTIA
State	:	CA
Zip	:	92870-3763
Country	:	US
Telephone Number	:	714-223-7000
Fax Number	:	714-223-7001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	07/01/2021

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