Individual
DR. CARL LAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1200 WILSHIRE BLVD, SUITE 205, LOS ANGELES, CA 90017-1908
(818) 897-5512
Mailing address
PO BOX 4572, SUNLAND, CA 91041-4572
(818) 897-5512
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
24820
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3390354
USAA MEMBERSHIP
CA
Enumeration date
09/12/2011
Last updated
09/12/2011
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