Provider Demographics
NPI:1235234279
Name:LAU, YAT HONG (MD)
Entity Type:Individual
Prefix:DR
First Name:YAT
Middle Name:HONG
Last Name:LAU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5017
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51102-5017
Mailing Address - Country:US
Mailing Address - Phone:712-252-9390
Mailing Address - Fax:712-252-9404
Practice Address - Street 1:230 NEBRASKA ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101-1733
Practice Address - Country:US
Practice Address - Phone:712-252-9390
Practice Address - Fax:712-252-9404
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA364832085R0001X
SD58202085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0483628Medicaid
IA14795OtherWELLMARK
E88059Medicare UPIN
IAI17088Medicare ID - Type Unspecified