Provider Demographics
NPI:1871694208
Name:LAU, THOMAS K L (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:K L
Last Name:LAU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 62060
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96839-2060
Mailing Address - Country:US
Mailing Address - Phone:808-941-3363
Mailing Address - Fax:
Practice Address - Street 1:2228 LILIHA ST
Practice Address - Street 2:STE. #105
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1650
Practice Address - Country:US
Practice Address - Phone:808-941-3363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-816207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000BDFKNMedicare ID - Type Unspecified