Lau, Stella Kim
Lau, Stella Kim is an individual health care provider with primary practice located at 4116 W Craig Rd Ste 104 , North Las Vegas NV 89032-2733. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Lau, Stella Kim can be contacted via phone (702) 631-2015.Contact Information
Primary practice address
4116 W Craig Rd Ste 104
North Las Vegas NV 89032-2733
Phone: (702) 631-2015
Fax: (702) 631-2511
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 12895 | California |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 634 | Hawaii |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 5949006-9934 | Utah |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 589 | Nevada |
Profile Details
| NPI number | 1275575722 |
|---|---|
| LBN Legal business name | Lau, Stella Kim |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 11th, 2006 |
| Last updated | Jun 23rd, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275575722 | NPPES |
| New Mexico | MEDICAID | 48830739 | |
| New Mexico | MEDICAID | 1275575722 | |
| New Mexico | MEDICAID | 950685 | |
| New Mexico | MEDICAID | 75507242 |
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