Provider Demographics
NPI:1740227040
Name:LAI, SEN BIN (MD)
Entity Type:Individual
Prefix:
First Name:SEN
Middle Name:BIN
Last Name:LAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2690 PACIFIC AVE
Mailing Address - Street 2:SUITE 290
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2657
Mailing Address - Country:US
Mailing Address - Phone:562-595-9799
Mailing Address - Fax:562-595-8884
Practice Address - Street 1:2690 PACIFIC AVE
Practice Address - Street 2:SUITE 290
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2657
Practice Address - Country:US
Practice Address - Phone:562-595-9799
Practice Address - Fax:562-595-8884
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32145174400000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A321450Medicaid
CA00A321450Medicaid
CAA26712Medicare UPIN