Provider Demographics
NPI:1164704508
Name:HENRY TSENG, DPM, A PODIATRIC MEDICAL CORPORATION
Entity Type:Organization
Organization Name:HENRY TSENG, DPM, A PODIATRIC MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:TSENG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:626-330-4886
Mailing Address - Street 1:2707 E VALLEY BLVD STE 303
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-3198
Mailing Address - Country:US
Mailing Address - Phone:626-330-4866
Mailing Address - Fax:626-330-7989
Practice Address - Street 1:2707 E VALLEY BLVD STE 303
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792
Practice Address - Country:US
Practice Address - Phone:626-330-4866
Practice Address - Fax:626-330-7989
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HENRY TSENG, DPM, A PODIATRIC MEDICAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-09-12
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site