Provider Demographics
NPI:1023179272
Name:TSAI, CHARLES (DC)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:TSAI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 DEEP VALLEY DR STE 207
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3654
Mailing Address - Country:US
Mailing Address - Phone:310-357-0699
Mailing Address - Fax:310-544-1969
Practice Address - Street 1:827 DEEP VALLEY DR STE 207
Practice Address - Street 2:
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3654
Practice Address - Country:US
Practice Address - Phone:310-357-0699
Practice Address - Fax:310-544-1969
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25527111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor