Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | A63853 | CA |
NPI | 1043398803 |
---|---|
Provider Name | George Lai |
First Address | Hayward, CA 94545-4203 |
Second Address | Hayward, CA 94545-4203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 13/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A638530 | (05) | CA |
G79907 | (02) |