Provider Demographics
NPI:1518034958
Name:LAI, YIH WEN (MD)
Entity Type:Individual
Prefix:
First Name:YIH
Middle Name:WEN
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 1:14350 WHITTIER BLVD
Mailing Address - Street 2:STE 225
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-2144
Mailing Address - Country:US
Mailing Address - Phone:562-945-8907
Mailing Address - Fax:562-945-4818
Practice Address - Street 1:14350 WHITTIER BLVD
Practice Address - Street 2:STE 225
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-2144
Practice Address - Country:US
Practice Address - Phone:562-945-8907
Practice Address - Fax:562-945-4818
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38785174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB77522Medicare UPIN
CAA38785Medicare ID - Type UnspecifiedPROVIDER NUMBER