Provider Demographics
NPI:1306034269
Name:TSAY, ELIZABETH M (OD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:M
Last Name:TSAY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:M
Other - Last Name:TSAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:PO BOX 206
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-0206
Mailing Address - Country:US
Mailing Address - Phone:909-446-2447
Mailing Address - Fax:
Practice Address - Street 1:425 W BONITA AVE STE 110B
Practice Address - Street 2:
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-2543
Practice Address - Country:US
Practice Address - Phone:909-394-0462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2021-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT13285T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWOP13285AMedicare PIN