Provider Demographics
NPI:1659397552
Name:LAI, TED Y (MD)
Entity Type:Individual
Prefix:
First Name:TED
Middle Name:Y
Last Name:LAI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:210 N GARFIELD AVE
Mailing Address - Street 2:#303
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1746
Mailing Address - Country:US
Mailing Address - Phone:626-571-6501
Mailing Address - Fax:626-571-4938
Practice Address - Street 1:210 N GARFIELD AVE
Practice Address - Street 2:#303
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1746
Practice Address - Country:US
Practice Address - Phone:626-571-6501
Practice Address - Fax:626-571-4938
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
CAA31371207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA87555Medicare UPIN