Provider Demographics
NPI:1114277738
Name:WILLIAM J TSAI MD INC
Entity Type:Organization
Organization Name:WILLIAM J TSAI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JEN
Authorized Official - Last Name:TSAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-955-0202
Mailing Address - Street 1:19742 MACARTHUR BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-2432
Mailing Address - Country:US
Mailing Address - Phone:949-955-0202
Mailing Address - Fax:949-955-0203
Practice Address - Street 1:19742 MACARTHUR BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-2432
Practice Address - Country:US
Practice Address - Phone:949-955-0202
Practice Address - Fax:949-955-0203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71679207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A716790Medicaid
CAH29939Medicare UPIN
CA00A716790Medicaid