Provider Demographics
NPI:1427033638
Name:TSAI, JEFFREY C (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:C
Last Name:TSAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1048 S GARFIELD AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-4768
Mailing Address - Country:US
Mailing Address - Phone:626-281-8288
Mailing Address - Fax:626-458-6400
Practice Address - Street 1:1048 S GARFIELD AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-4768
Practice Address - Country:US
Practice Address - Phone:626-281-8288
Practice Address - Fax:626-458-6400
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA30994174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA84158Medicare UPIN