Provider Demographics
NPI:1396846416
Name:BENJAMIN CK LAU MD INC
Entity type:Organization
Organization Name:BENJAMIN CK LAU MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:CK
Authorized Official - Last Name:LAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-876-6400
Mailing Address - Street 1:4306 GEARY BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-3059
Mailing Address - Country:US
Mailing Address - Phone:415-876-6400
Mailing Address - Fax:415-876-6402
Practice Address - Street 1:4306 GEARY BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-3059
Practice Address - Country:US
Practice Address - Phone:415-876-6400
Practice Address - Fax:415-876-6402
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BENJAMIN CK LAU MD INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-25
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60654208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG85794Medicare UPIN