Provider Demographics
NPI:1750763439
Name:LAI, ISABELLA (MD)
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:
Last Name:LAI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10780 SANTA MONICA BLVD STE 350
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-4779
Mailing Address - Country:US
Mailing Address - Phone:424-274-1550
Mailing Address - Fax:
Practice Address - Street 1:10780 SANTA MONICA BLVD STE 350
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-4779
Practice Address - Country:US
Practice Address - Phone:424-274-1550
Practice Address - Fax:920-352-4156
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-18
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171100000X, 261QR0404X
CAA149405207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No171100000XOther Service ProvidersAcupuncturist
No261QR0404XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Cardiac Facilities