Provider Demographics
NPI:1841232717
Name:LAI, MAI K (MD)
Entity Type:Individual
Prefix:
First Name:MAI
Middle Name:K
Last Name:LAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 S ARROYO PKWY STE 320
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3264
Mailing Address - Country:US
Mailing Address - Phone:626-577-9495
Mailing Address - Fax:
Practice Address - Street 1:675 S ARROYO PKWY STE 320
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3264
Practice Address - Country:US
Practice Address - Phone:626-577-9495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA90320207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A903200Medicaid
CAWA90320AMedicare PIN
CAWA90320Medicare ID - Type Unspecified
CAWA90320BMedicare PIN
CA00A903200Medicaid