Provider Demographics
NPI:1457412140
Name:LAU, ANGIE KEI PANG (OD)
Entity Type:Individual
Prefix:DR
First Name:ANGIE
Middle Name:KEI PANG
Last Name:LAU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5723B MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-4208
Mailing Address - Country:US
Mailing Address - Phone:415-282-4544
Mailing Address - Fax:
Practice Address - Street 1:2540 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2512
Practice Address - Country:US
Practice Address - Phone:415-282-4544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12600T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist