Provider Demographics
NPI:1003218975
Name:LAU, KARIE ANNE (PHARMD)
Entity Type:Individual
Prefix:
First Name:KARIE
Middle Name:ANNE
Last Name:LAU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13635 SOMERSET RD
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-4075
Mailing Address - Country:US
Mailing Address - Phone:949-981-7436
Mailing Address - Fax:
Practice Address - Street 1:13635 SOMERSET RD
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-4075
Practice Address - Country:US
Practice Address - Phone:949-981-7436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71470183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist