Provider Demographics
NPI:1245902238
Name:LAU, JUDY WAN HO (RPH)
Entity type:Individual
Prefix:
First Name:JUDY WAN HO
Middle Name:
Last Name:LAU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16146 LA MONDE ST
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-4230
Mailing Address - Country:US
Mailing Address - Phone:626-324-7888
Mailing Address - Fax:
Practice Address - Street 1:15614 WHITTWOOD LN
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-2324
Practice Address - Country:US
Practice Address - Phone:562-371-9004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85011183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist