Provider Demographics
NPI:1699473835
Name:LAI, CAROL KING YAN
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:KING YAN
Last Name:LAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1427 SAN MARINO AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91108-2047
Mailing Address - Country:US
Mailing Address - Phone:626-583-8889
Mailing Address - Fax:626-583-8870
Practice Address - Street 1:462 W WINNIE WAY
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-7957
Practice Address - Country:US
Practice Address - Phone:626-375-1267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16253225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist