Provider Demographics
NPI:1548595580
Name:LAU, KAREN KA LING (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:KA LING
Last Name:LAU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2540 N SANTIAGO BLVD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-1862
Mailing Address - Country:US
Mailing Address - Phone:714-921-1030
Mailing Address - Fax:714-921-1032
Practice Address - Street 1:2540 N SANTIAGO BLVD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-1862
Practice Address - Country:US
Practice Address - Phone:714-921-1030
Practice Address - Fax:714-921-1032
Is Sole Proprietor?:No
Enumeration Date:2009-10-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA109171207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACG5665OtherRAIL ROAD MEDICARE - GROUP PTAN
1912919804OtherNPI - TYPE 2
CAA109171OtherSTATE LICENSE
CAP00837290OtherRAIL ROAD MEDICARE - PROVIDER PTAN
CAW1514OtherMEDICARE PTAN - TYPE 2
CACG5665OtherRAIL ROAD MEDICARE - GROUP PTAN