Provider Demographics
NPI:1619597887
Name:LAI, NGAN KI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NGAN
Middle Name:KI
Last Name:LAI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:LAI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2091 CALIFORNIA ST APT 322
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-1439
Mailing Address - Country:US
Mailing Address - Phone:858-220-1939
Mailing Address - Fax:
Practice Address - Street 1:350 HAWTHORNE AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3108
Practice Address - Country:US
Practice Address - Phone:510-869-6524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-17
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA74932183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist