Provider Demographics
NPI:1003204843
Name:LEUNG-LAU, KIT C
Entity Type:Individual
Prefix:
First Name:KIT
Middle Name:C
Last Name:LEUNG-LAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4946 ARDSLEY DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-3805
Mailing Address - Country:US
Mailing Address - Phone:626-475-2753
Mailing Address - Fax:626-286-6620
Practice Address - Street 1:4946 ARDSLEY DR
Practice Address - Street 2:
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-3805
Practice Address - Country:US
Practice Address - Phone:626-475-2753
Practice Address - Fax:626-286-6620
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-01
Last Update Date:2015-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT1058225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist