Provider Demographics
NPI:1700176971
Name:LAI, BRIAN (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:LAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1653 7TH ST UNIT 7548
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90406-8012
Mailing Address - Country:US
Mailing Address - Phone:310-564-6139
Mailing Address - Fax:626-609-4195
Practice Address - Street 1:11500 W OLYMPIC BLVD STE 502
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1528
Practice Address - Country:US
Practice Address - Phone:310-985-1779
Practice Address - Fax:626-609-4195
Is Sole Proprietor?:No
Enumeration Date:2011-04-08
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA135483207L00000X, 207LP2900X
PAMD454707207L00000X
NY283943207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology