Provider Demographics
NPI:1649643586
Name:LAI, DAVID ANDREW (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ANDREW
Last Name:LAI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:ANDREW
Other - Last Name:LAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:623 CLARIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-2102
Mailing Address - Country:US
Mailing Address - Phone:714-876-8837
Mailing Address - Fax:
Practice Address - Street 1:1707 GRANT AVE
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-2229
Practice Address - Country:US
Practice Address - Phone:415-897-4171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-31
Last Update Date:2015-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist