Provider Demographics
NPI:1306845102
Name:TZENG, THOMAS S (MD)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:S
Last Name:TZENG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 6448
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90609-6448
Mailing Address - Country:US
Mailing Address - Phone:562-698-6857
Mailing Address - Fax:562-698-4431
Practice Address - Street 1:9001 W SHARON WAY
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-3456
Practice Address - Country:US
Practice Address - Phone:562-698-6857
Practice Address - Fax:562-698-4431
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA37994208600000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A379940Medicaid
P00017121OtherRAILROAD MEDICARE
CA00A379940Medicaid
A37994Medicare ID - Type Unspecified