Provider Demographics
NPI:1487996492
Name:KATAMURA, MONICA LAU (MD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:LAU
Last Name:KATAMURA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:P
Other - Last Name:LAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9300 VALLEY CHILDRENS PL
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93636-8761
Mailing Address - Country:US
Mailing Address - Phone:593-536-4255
Mailing Address - Fax:559-353-6441
Practice Address - Street 1:9300 VALLEY CHILDRENS PL # 01
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93636-8761
Practice Address - Country:US
Practice Address - Phone:559-353-6425
Practice Address - Fax:559-353-6441
Is Sole Proprietor?:No
Enumeration Date:2013-03-18
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA284726207R00000X, 208000000X
CAC176845208000000X, 207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics