Individual
JONATHAN B LAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
716 W BROADWAY, GLENDALE, CA 91204-1010
(818) 550-0900
(505) 293-1524
Mailing address
PO BOX 5486, ORANGE, CA 92863-5486
(818) 550-0900
(505) 293-1524
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
20A7545
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX75450
—
CA
Enumeration date
01/31/2007
Last updated
05/07/2024
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