MEDICARE: DR. STELLA KIM LAU O.D.

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	152W00000X	Optometrist	12895	CA
2	152W00000X	Optometrist	634	HI
3	152W00000X	Optometrist	5949006-9934	UT
4	152W00000X	Optometrist	589	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275575722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STELLA KIM LAU O.D.

Provider Business Mailing Address
First Line	:	8282 BEAVERBROOK WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-0837
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4116 W CRAIG RD STE 104
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-2733
Country	:	US
Telephone Number	:	702-631-2015
Fax Number	:	702-631-2511

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

Provider Enumeration Date	:	06/11/2006
Last Update Date	:	02/12/2026

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Directions to “ DR. STELLA KIM LAU O.D.” Practice Location

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