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Organization

WHITE MEMORIAL MEDICAL GROUP, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALAN C. K. LAU M.D. (PRESIDENT)
(323) 987-1362
Entity
Organization

Contact information

Practice address
1701 E CESAR E CHAVEZ AVE, SUITE 510, LOS ANGELES, CA 90033-2464
(323) 987-1362
(323) 987-1365
Mailing address
PO BOX 51741, LOS ANGELES, CA 90051-6041
(323) 987-1362
(323) 987-1365

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3598
CA
332B00000X
Durable Medical Equipment & Medical Supplies
E3598
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CR0076
RR MEDICARE
05
GRE001650
CA
Enumeration date
09/16/2008
Last updated
08/10/2017
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