Active NPI
Michael Anthony Lauw, PHARMD
- Pharmacist
- Grand Terrace, CA
National Provider Identifier
1295326684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 83539
- Practice address
- 12071 Mount Vernon Ave
Grand Terrace, CA 92313-5173 - Phone
- (909) 514-0287
- NPI assigned
- Jan 29, 2021
- Last updated
- Jan 29, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 83539 | CA | Primary |
Addresses
Primary practice location
12071 Mount Vernon Ave
Grand Terrace, CA 92313-5173
Mailing address
12071 Mount Vernon Ave
Grand Terrace, CA 92313-5173
Phone (909) 514-0287
Other practice location 1
11234 Anderson St Ste Lobby
Loma Linda, CA 92354-2804
Phone (909) 558-4500 ext. 50784
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83539 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS LLC | Past | Accepting new patients | |
| Garfield Beach CVS, L.L.C. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611878400000",
"number": "1295326684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12071 MOUNT VERNON AVE",
"city": "GRAND TERRACE",
"state": "CA",
"postal_code": "923135173",
"telephone_number": "909-514-0287"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12071 MOUNT VERNON AVE",
"city": "GRAND TERRACE",
"state": "CA",
"postal_code": "923135173",
"telephone_number": "909-514-0287"
}
],
"practiceLocations": [
{
"address_1": "11234 Anderson St Ste Lobby",
"address_purpose": "LOCATION",
"city": "Loma Linda",
"state": "CA",
"postal_code": "923542804",
"country_code": "US",
"telephone_number": "909-558-4500 x50784",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LAUW",
"first_name": "MICHAEL",
"middle_name": "ANTHONY",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-29",
"last_updated": "2021-01-29",
"certification_date": "2021-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "83539",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Terrace, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.