Individual provider Active NPI

Stanley Kwong Lau, M.D.

  • Cardiovascular Disease Physician
  • San Gabriel, CA
National Provider Identifier
1548222813
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A46648 Issued in CA
Practice address
506 W Valley Blvd
San Gabriel, CA 91776-3731
Phone
(626) 308-3800
Fax
(626) 308-1899
NPI assigned
Apr 4, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X A46648 CA Primary
Interventional Cardiology Physician 207RI0011X A46648 CA

Addresses

Primary practice location

506 W Valley Blvd
San Gabriel, CA 91776-3731

Mailing address

506 W Valley Blvd
San Gabriel, CA 91776-3731
Phone (626) 308-3800

Other practice location 1

625 W College St Ste 201
Los Angeles, CA 90012-3059
Phone (626) 308-3800

Other identifiers 4

IdentifierTypeStateIssuer
00A466480MedicaidCA
00A466480OtherCABLUE SHIELD OF CA
RHD136312OtherCAFLURO/X-RAY SUPERVISOR
10959167OtherCACAQH #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060731000313 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 3476566977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Heart Centers a Medical CorporationGroup PAC ID 7012944473, 16 clinicians

Practice addresses (Care Compare)

506 W Valley Blvd
San Gabriel, CA 91776-5716
Phone (626) 308-3800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A46648CAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Heart Centers a Medical Corporation Cardiovascular Disease CurrentSince Oct 1, 1999 Accepting new patients
Southern California Heart Centers Inc Cardiovascular Disease Past Accepting new patients
Insignia Health Corp PastSince Feb 12, 2019 Accepting new patients

Locations

625 W College St
Ste 201
Los Angeles, CA 90012
Phone (213) 617-8301

711 W College St
Ste 300
Los Angeles, CA 90012
Phone (213) 587-3341

415 W Valley Blvd
Ste D
San Gabriel, CA 91776
Phone (626) 308-3800

506 W Valley Blvd
San Gabriel, CA 91776
Phone (626) 308-3800

506 W Valley Blvd
Ste 100
San Gabriel, CA 91776
Phone (626) 308-3800

506 W Valley Blvd
Ste 300
San Gabriel, CA 91776
Phone (213) 977-7442

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1548222813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 W VALLEY BLVD",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763731",
            "telephone_number": "626-308-3800",
            "fax_number": "626-308-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 W VALLEY BLVD",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763731",
            "telephone_number": "626-308-3800",
            "fax_number": "626-308-1899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "625 W College St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900123059",
            "country_code": "US",
            "telephone_number": "626-308-3800",
            "fax_number": "626-308-1899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAU",
        "first_name": "STANLEY",
        "middle_name": "KWONG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A46648",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A46648",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A466480",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "00A466480",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLURO/X-RAY SUPERVISOR",
            "identifier": "RHD136312",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH #",
            "identifier": "10959167",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

Verify at the official NPI Registry.