Provider Demographics
NPI:1194845164
Name:LAI, STEPHEN (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:LAI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8985 MIRA MESA BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-2716
Mailing Address - Country:US
Mailing Address - Phone:858-566-3490
Mailing Address - Fax:858-566-2979
Practice Address - Street 1:8985 MIRA MESA BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-2716
Practice Address - Country:US
Practice Address - Phone:858-566-3490
Practice Address - Fax:858-566-2979
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32341183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist