Basic Information
| Provider Information | |||||||||
| NPI: | 1992072193 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAI | ||||||||
| FirstName: | ANGELA | ||||||||
| MiddleName: | HELEN | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 450 STANYAN ST | ||||||||
| Address2: | 6TH FLOOR | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4156804135 | ||||||||
| FaxNumber: | 4155205153 | ||||||||
| Practice Location | |||||||||
| Address1: | 450 STANYAN ST | ||||||||
| Address2: | ROOM 503 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941171019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4157505909 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/16/2011 | ||||||||
| LastUpdateDate: | 10/12/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A125916 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.