Provider Demographics
NPI:1497515167
Name:PROMETHEUS MEDICAL INNOVATIONS A CALIFORNIA PROFESSIONAL MEDICAL CO
Entity Type:Organization
Organization Name:PROMETHEUS MEDICAL INNOVATIONS A CALIFORNIA PROFESSIONAL MEDICAL CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILSON SHU-CHUN
Authorized Official - Middle Name:
Authorized Official - Last Name:TSAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-588-6551
Mailing Address - Street 1:160 ALAMO PLZ UNIT 180
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:CA
Mailing Address - Zip Code:94507-4008
Mailing Address - Country:US
Mailing Address - Phone:925-588-6551
Mailing Address - Fax:925-852-1667
Practice Address - Street 1:2637 SHADELANDS DR
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2512
Practice Address - Country:US
Practice Address - Phone:925-588-6551
Practice Address - Fax:925-852-1667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty