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NPI Code Detail

MEDICARE: SYDNEY LAO

MEDICARE: SYDNEY LAO
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
1106S00000XBehavior Technician
2225XP0200XPediatric Occupational Therapist22447CA

General Provider Information

NPI Number : 1356888036
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYDNEY LAO
Provider Business Mailing Address
First Line : 10431 COMMERCE ST STE A
Second Line :
City : REDLANDS
State : CA
Zip : 92374-0110
Country : US
Telephone Number : 909-783-1111
Fax Number : 909-796-2122
Provider Business Practice Location Address
First Line : 10431 COMMERCE ST STE A
Second Line :
City : REDLANDS
State : CA
Zip : 92374-0110
Country : US
Telephone Number : 909-783-1111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2017
Last Update Date : 07/08/2021

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Directions to “ SYDNEY LAO ” Practice Location

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