Provider Demographics
NPI:1154385961
Name:LAI, ALBERT (MD)
Entity type:Individual
Prefix:DR
First Name:ALBERT
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 1:1041 E YORBA LINDA BLVD
Mailing Address - Street 2:STE 210
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-3763
Mailing Address - Country:US
Mailing Address - Phone:714-223-7000
Mailing Address - Fax:714-223-7001
Practice Address - Street 1:1041 E YORBA LINDA BLVD
Practice Address - Street 2:STE 210
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3763
Practice Address - Country:US
Practice Address - Phone:714-223-7000
Practice Address - Fax:714-223-7001
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
CAA86192208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ28164ZOtherMEDICARE GROUP PTAN
CAZZZ28164ZOtherMEDICARE GROUP PTAN