Provider Demographics
NPI:1144556416
Name:LAI, MARCUS WING KAI (RD)
Entity type:Individual
Prefix:MR
First Name:MARCUS
Middle Name:WING KAI
Last Name:LAI
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2818 SANTIAGO ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-1667
Mailing Address - Country:US
Mailing Address - Phone:279-759-1396
Mailing Address - Fax:
Practice Address - Street 1:1268 42ND AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-1209
Practice Address - Country:US
Practice Address - Phone:415-218-2778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-21
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY988283133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered