Provider Demographics
NPI:1437221272
Name:LAH, JOHN J (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:LAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOON
Other - Middle Name:KYUNG
Other - Last Name:LAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15141 WHITTIER BLVD
Mailing Address - Street 2:SUITE #260
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-2135
Mailing Address - Country:US
Mailing Address - Phone:562-698-0306
Mailing Address - Fax:562-693-7016
Practice Address - Street 1:15141 WHITTIER BLVD
Practice Address - Street 2:SUITE #260
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-2135
Practice Address - Country:US
Practice Address - Phone:562-698-0306
Practice Address - Fax:562-693-7016
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76371207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A763710OtherMEDI-CAL PROVIDER RENDERING NUMBER
CA00A763710OtherMEDI-CAL PROVIDER RENDERING NUMBER