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Organization
WHITE MEMORIAL MEDICAL GROUP, INC.
Active
Organization
WHITE MEMORIAL MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN C. K. LAU M.D. (PRESIDENT)
(323) 987-1362
Entity
Organization
Contact information
Practice address
1701 E CESAR E CHAVEZ AVE, SUITE 510, LOS ANGELES, CA 90033-2464
(323) 987-1362
(323) 987-1365
Mailing address
PO BOX 51741, LOS ANGELES, CA 90051-6041
(323) 987-1362
(323) 987-1365
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3598
CA
332B00000X
Durable Medical Equipment & Medical Supplies
E3598
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CR0076
RR MEDICARE
—
05
—
GRE001650
—
CA
Enumeration date
09/16/2008
Last updated
08/10/2017
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