MEDICARE: LAWRENCE R LAI MD INC

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	A43524	CA

General Provider Information

NPI Number	:	1437362472
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAWRENCE R LAI MD INC

Provider Business Mailing Address
First Line	:	131 W WILLOW ST
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91768-1829
Country	:	US
Telephone Number	:	909-623-8521
Fax Number	:	909-865-7583

Provider Business Practice Location Address
First Line	:	131 W WILLOW ST
Second Line	:
City	:	POMONA
State	:	CA
Zip	:	91768-1829
Country	:	US
Telephone Number	:	909-623-8521
Fax Number	:	909-865-7583

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LAWRENCE R LAI
Credential	:	M.D.
Telephone Number	:	909-623-8521

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	08/22/2020

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