Provider Demographics
NPI:1528345535
Name:LAU, CLARENCE
Entity type:Individual
Prefix:MR
First Name:CLARENCE
Middle Name:
Last Name:LAU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3931 ALEMANY BLVD STE 2001
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-3293
Mailing Address - Country:US
Mailing Address - Phone:650-757-5175
Mailing Address - Fax:650-757-5180
Practice Address - Street 1:3931 ALEMANY BLVD STE 2001
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94132-3293
Practice Address - Country:US
Practice Address - Phone:650-757-5175
Practice Address - Fax:650-757-5180
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42343183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist