Provider Demographics
NPI:1316196397
Name:LAI, HOANG MINH (MD)
Entity Type:Individual
Prefix:DR
First Name:HOANG
Middle Name:MINH
Last Name:LAI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:39755 MURRIETA HOT SPRINGS RD
Mailing Address - Street 2:SUITE E-130
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-9151
Mailing Address - Country:US
Mailing Address - Phone:951-894-1131
Mailing Address - Fax:951-696-6742
Practice Address - Street 1:39755 MURRIETA HOT SPRINGS RD
Practice Address - Street 2:SUITE E-130
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-9151
Practice Address - Country:US
Practice Address - Phone:951-894-1131
Practice Address - Fax:951-696-6742
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2016-08-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY60250309207R00000X
CAA123868207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03054735Medicaid
CA1316196397Medicaid
NY03054735Medicaid