Individual provider Active NPI

Lydia Yeeyen Lau, PA-C

  • Physician Assistant
  • Tustin, CA
National Provider Identifier
1922629831
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA58610 Issued in CA
Practice address
1 Hope Dr
Tustin, CA 92782-0221
Phone
(714) 247-0300
Fax
(714) 259-1598
NPI assigned
May 1, 2020
Last updated
May 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA58610 CA Primary

Addresses

Primary practice location

1 Hope Dr
Tustin, CA 92782-0221

Mailing address

14642 Newport Ave Ste 300
Tustin, CA 92780-6059
Phone (714) 247-0300

Other practice location 1

1100B N Tustin Ave Ste A
Santa Ana, CA 92705-3505
Phone (714) 247-0300

Other practice location 2

14642 Newport Ave Ste 200
Tustin, CA 92780-6058
Phone (714) 247-0300

Other practice location 3

947 S Anaheim Blvd Ste 260
Anaheim, CA 92805-5591
Phone (714) 247-0300

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240918003310 CA Practitioner - Physician Assistant 3971970922 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA58610CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hurtt Family Health Clinic Inc CurrentSince Jun 17, 2024 Accepting new patients
Hurtt Family Health Clinic Inc. CurrentSince Jun 17, 2024 Accepting new patients
Hurtt Family Health Clinic Inc. Past Accepting new patients

Locations

947 S Anaheim Blvd
Ste 260
Anaheim, CA 92805

1100 N Tustin Ave
Ste A
Santa Ana, CA 92705
Phone (714) 835-6055

1 Hope Dr
Tustin, CA 92782
Phone (714) 247-4398

1 Hope Dr
Ste B
Tustin, CA 92782

14642 Newport Ave
Ste 300
Tustin, CA 92780
Phone (714) 669-4422

Interoperability endpoints

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

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": "1588291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1922629831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14642 NEWPORT AVE STE 300",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927806059",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOPE DR",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927820221",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100B N Tustin Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927053505",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14642 Newport Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927806058",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "947 S Anaheim Blvd Ste 260",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928055591",
            "country_code": "US",
            "telephone_number": "714-247-0300",
            "fax_number": "714-259-1598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAU",
        "first_name": "LYDIA",
        "middle_name": "YEEYEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-01",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA58610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.