Provider Demographics
NPI:1093366049
Name:JEFFREY LAI, MD, INC.
Entity Type:Organization
Organization Name:JEFFREY LAI, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:C
Authorized Official - Last Name:LAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:424-363-7488
Mailing Address - Street 1:3655 LOMITA BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-1910
Mailing Address - Country:US
Mailing Address - Phone:424-363-7488
Mailing Address - Fax:424-363-7499
Practice Address - Street 1:3655 LOMITA BLVD STE 202
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-1910
Practice Address - Country:US
Practice Address - Phone:424-363-7488
Practice Address - Fax:424-363-7499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-21
Last Update Date:2020-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Single Specialty