Individual
JACOB E LAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2811 N VENTURA RD, OXNARD, CA 93036-2213
(805) 983-0343
(805) 983-3285
Mailing address
2811 N VENTURA RD, OXNARD, CA 93036-2213
(805) 983-0343
(805) 983-3285
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A75621
CA
207ND0101X
MOHS-Micrographic Surgery Physician
A75621
CA
207ND0900X
Dermatopathology Physician
A75621
CA
207NS0135X
Procedural Dermatology Physician
A75621
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A756210
MEDI-CAL
—
Enumeration date
02/22/2007
Last updated
05/24/2011
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