Provider Demographics
NPI:1639315955
Name:ANNIE Y. LAU, M.D.
Entity Type:Organization
Organization Name:ANNIE Y. LAU, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNIE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:LAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-429-2529
Mailing Address - Street 1:3315 WATT AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-3600
Mailing Address - Country:US
Mailing Address - Phone:916-481-0777
Mailing Address - Fax:916-481-1881
Practice Address - Street 1:3315 WATT AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-3600
Practice Address - Country:US
Practice Address - Phone:916-481-0777
Practice Address - Fax:916-481-1881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-17
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38392207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A383920Medicaid
CA00A383920Medicaid
CA00A383921Medicare PIN