Individual
DERRICK LAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4605 BROCKTON AVE STE 100, RIVERSIDE, CA 92506-0107
(951) 686-4911
Mailing address
1331 W MAITLAND ST, ONTARIO, CA 91762-4739
(626) 643-4388
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT35491-TLG
CA
Other
Enumeration date
04/17/2023
Last updated
08/21/2024
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