Provider Demographics
NPI:1477209260
Name:LAU, MICHEL (DACM, LAC)
Entity Type:Individual
Prefix:
First Name:MICHEL
Middle Name:
Last Name:LAU
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6150 MISSION ST STE 111
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94014-2075
Mailing Address - Country:US
Mailing Address - Phone:415-323-5828
Mailing Address - Fax:
Practice Address - Street 1:6150 MISSION ST STE 111
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94014-2075
Practice Address - Country:US
Practice Address - Phone:415-323-5828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-01
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19193171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist