Provider Demographics
NPI:1437616604
Name:TSAI, BRIAN
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:TSAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4171 OCEANSIDE BLVD STE 100C
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-6023
Mailing Address - Country:US
Mailing Address - Phone:760-283-7180
Mailing Address - Fax:
Practice Address - Street 1:4171 OCEANSIDE BLVD STE 100C
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-6023
Practice Address - Country:US
Practice Address - Phone:760-283-7180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA105902122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program