Provider Demographics
NPI:1508905159
Name:LAI, CHRISTOPHER C (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:C
Last Name:LAI
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 1:196 W LEGION RD
Mailing Address - Street 2:
Mailing Address - City:BRAWLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92227-7713
Mailing Address - Country:US
Mailing Address - Phone:209-956-7725
Mailing Address - Fax:760-344-4309
Practice Address - Street 1:196 W LEGION RD
Practice Address - Street 2:
Practice Address - City:BRAWLEY
Practice Address - State:CA
Practice Address - Zip Code:92227-7713
Practice Address - Country:US
Practice Address - Phone:209-956-7725
Practice Address - Fax:760-344-4309
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66701207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A667010Medicaid
CAWA66701AMedicare ID - Type Unspecified
CAG87427Medicare UPIN