Provider Demographics
NPI:1891216792
Name:LAI, PEI CHING (LAC)
Entity Type:Individual
Prefix:
First Name:PEI CHING
Middle Name:
Last Name:LAI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6253 GLORIA ST
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-4523
Mailing Address - Country:US
Mailing Address - Phone:909-485-9530
Mailing Address - Fax:
Practice Address - Street 1:653 E E ST STE 106
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-4257
Practice Address - Country:US
Practice Address - Phone:909-786-2893
Practice Address - Fax:909-786-2976
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17550171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist