Provider Demographics
NPI:1730150608
Name:LAI, KHANG HUY (D O)
Entity type:Individual
Prefix:DR
First Name:KHANG
Middle Name:HUY
Last Name:LAI
Suffix:
Gender:M
Credentials:D O
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:15701 ROCKFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2801
Mailing Address - Country:US
Mailing Address - Phone:949-457-9900
Mailing Address - Fax:949-457-9922
Practice Address - Street 1:15701 ROCKFIELD BLVD
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2801
Practice Address - Country:US
Practice Address - Phone:949-457-9900
Practice Address - Fax:949-457-9922
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A82262081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI49451Medicare UPIN