Individual provider Active NPI

Fred G Lau, MD

  • Diagnostic Radiology Physician
  • Norwalk, CA
National Provider Identifier
1881671048
Registry record updated Mar 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G71747 Issued in CA
Practice address
13100 Studebaker Rd
Norwalk, CA 90650-2531
Phone
(562) 868-3751
Fax
(562) 868-9742
NPI assigned
Dec 29, 2005
Last updated
Mar 4, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X K4121 TX
Diagnostic Radiology Physician 2085R0202X G71747 CA Primary

Addresses

Primary practice location

13100 Studebaker Rd
Norwalk, CA 90650-2531

Mailing address

3350 E Birch St
Suite #105
Brea, CA 92821-6264
Phone (714) 646-8649

Other identifiers 1

IdentifierTypeStateIssuer
105245802MedicaidTX

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K4121TXMDSpecialist
G71747CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Simonmed Imaging a Professional Corporation Diagnostic Radiology Past Accepting new patients
C David Garvin, MD, PA Specialist Past Accepting new patients
Advanced Medical Imaging of North Texas LP Diagnostic Radiology Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EIAEAD

Organizations & group practices 3

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299196800000",
    "number": "1881671048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 E BIRCH ST",
            "address_2": "SUITE #105",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928216264",
            "telephone_number": "714-646-8649",
            "fax_number": "714-646-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13100 STUDEBAKER RD",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906502531",
            "telephone_number": "562-868-3751",
            "fax_number": "562-868-9742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAU",
        "first_name": "FRED",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2011-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "K4121",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G71747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105245802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2011; 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.