Provider Demographics
NPI:1245603059
Name:TENG, CRYSTAL TSAI (PA)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:TSAI
Last Name:TENG
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22018 E SNOW CREEK DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-1495
Mailing Address - Country:US
Mailing Address - Phone:909-595-8525
Mailing Address - Fax:
Practice Address - Street 1:3160 E DEL MAR BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-4649
Practice Address - Country:US
Practice Address - Phone:626-397-2400
Practice Address - Fax:626-270-2499
Is Sole Proprietor?:No
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA52989363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical