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Individual

DR. CHU KWAN LAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
632 W GIBSON RD, WOODLAND, CA 95695
(530) 666-1631
Mailing address
632 W GIBSON RD, WOODLAND, CA 95695
(530) 666-1631

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G65881
CA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
G65881
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00G658810
BLUE SHIELD
CA
01
460000308
RR MEDICARE
CA
01
460001209
MEDICARE RAILROAD
CA
05
OOG658810
CA
Enumeration date
07/31/2006
Last updated
10/06/2009
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