Provider Demographics
NPI:1588120398
Name:LAU, MUI THIN (PHARM D)
Entity type:Individual
Prefix:
First Name:MUI
Middle Name:THIN
Last Name:LAU
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8621 ORISON CT
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-3996
Mailing Address - Country:US
Mailing Address - Phone:913-244-4853
Mailing Address - Fax:
Practice Address - Street 1:4005 MANZANITA AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-1770
Practice Address - Country:US
Practice Address - Phone:916-483-2691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-17
Last Update Date:2019-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79959183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA79959OtherCALIFORNIA BOARD OF PHARMACY