Provider Demographics
NPI:1124061734
Name:MELANIE M. LAU, M.D., INC.
Entity type:Organization
Organization Name:MELANIE M. LAU, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LAU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-536-3690
Mailing Address - Street 1:1329 LUSITANA STREET
Mailing Address - Street 2:SUITE 406
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2412
Mailing Address - Country:US
Mailing Address - Phone:808-536-3690
Mailing Address - Fax:808-536-1638
Practice Address - Street 1:1329 LUSITANA STREET
Practice Address - Street 2:SUITE 406
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2412
Practice Address - Country:US
Practice Address - Phone:808-536-3690
Practice Address - Fax:808-536-1638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-7538207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI03995101Medicaid
HIH55530Medicare PIN
HIF87840Medicare UPIN