Individual
DR. SAMANTHA FONG-TING LAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 HOAG DRIVE BUILDING 41, NEWPORT BEACH, CA 92663
(949) 764-7647
(657) 242-7720
Mailing address
PO BOX 3589, NEWPORT BEACH, CA 92659-8589
(657) 241-3600
(657) 241-7708
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A142174
CA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
288718
NY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
A142174
CA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
A142174
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05535653
—
NY
Enumeration date
04/08/2014
Last updated
06/23/2021
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