Individual provider Active NPI

Mandy Quynh Lau

  • Pharmacist
  • La Habra, CA
National Provider Identifier
1205237328
Registry record updated Sep 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
55378 Issued in CA
Practice address
1390 S Beach Blvd
La Habra, CA 90631-6374
Phone
(562) 697-9324
NPI assigned
Sep 8, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 55378 CA Primary

Addresses

Primary practice location

1390 S Beach Blvd
La Habra, CA 90631-6374

Mailing address

9333 Siskin Ave
Fountain Valley, CA 92708-6553
Phone (714) 654-9027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
55378CAMDPhysician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410134400000",
    "number": "1205237328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9333 SISKIN AVE",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927086553",
            "telephone_number": "714-654-9027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 S BEACH BLVD",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906316374",
            "telephone_number": "562-697-9324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAU",
        "first_name": "MANDY",
        "middle_name": "QUYNH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2014-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "55378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Habra, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.