Provider Demographics
NPI:1841361532
Name:LAI, ANDREW (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:LAI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2345 FAIR OAKS BLVD
Mailing Address - Street 2:OUTPATIENT PHARMACY
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-4708
Mailing Address - Country:US
Mailing Address - Phone:916-480-6506
Mailing Address - Fax:916-480-6724
Practice Address - Street 1:2345 FAIR OAKS BLVD
Practice Address - Street 2:OUTPATIENT PHARMACY
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-4708
Practice Address - Country:US
Practice Address - Phone:916-480-6506
Practice Address - Fax:916-480-6724
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50333183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist