Provider Demographics
NPI:1679855282
Name:LAU, ALBERT (RPH)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:
Last Name:LAU
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:ING
Other - Middle Name:IK
Other - Last Name:LAU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2550 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-1614
Mailing Address - Country:US
Mailing Address - Phone:415-587-9000
Mailing Address - Fax:
Practice Address - Street 1:2550 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94132-1614
Practice Address - Country:US
Practice Address - Phone:415-587-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH 01355183500000X
NV08646183500000X
CARPH38361183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist