Provider Demographics
NPI:1164705562
Name:LAU, TUONG
Entity Type:Individual
Prefix:
First Name:TUONG
Middle Name:
Last Name:LAU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2008 PROWSE ST
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-2021
Mailing Address - Country:US
Mailing Address - Phone:408-952-9006
Mailing Address - Fax:
Practice Address - Street 1:2215 N BROADWAY # 200
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-2663
Practice Address - Country:US
Practice Address - Phone:714-221-6400
Practice Address - Fax:714-221-6401
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health