Provider Demographics
NPI:1316488265
Name:TIFFANNY LAI, O.D. INC.
Entity type:Organization
Organization Name:TIFFANNY LAI, O.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFANNY
Authorized Official - Middle Name:N
Authorized Official - Last Name:LAI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:408-472-7088
Mailing Address - Street 1:10717 NEW BORO AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89144-4405
Mailing Address - Country:US
Mailing Address - Phone:408-472-7088
Mailing Address - Fax:
Practice Address - Street 1:236 1/2 S BEVERLY DR
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3805
Practice Address - Country:US
Practice Address - Phone:310-361-0607
Practice Address - Fax:800-561-9671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-12
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14236TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty