Provider Demographics
NPI:1386701852
Name:LAI, CORREY PO-HONG (LAC)
Entity type:Individual
Prefix:MS
First Name:CORREY
Middle Name:PO-HONG
Last Name:LAI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 OREGON DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95822-2716
Mailing Address - Country:US
Mailing Address - Phone:916-454-1918
Mailing Address - Fax:916-454-3218
Practice Address - Street 1:2001 OREGON DR.
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822
Practice Address - Country:US
Practice Address - Phone:916-454-1918
Practice Address - Fax:916-454-3218
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC0076320171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist