Provider Demographics
NPI:1497910129
Name:DR THOMAS TSENG MEDICAL CLINIC INC
Entity Type:Organization
Organization Name:DR THOMAS TSENG MEDICAL CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:MU-REN
Authorized Official - Last Name:TSENG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:626-289-9478
Mailing Address - Street 1:880 S ATLANTIC BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-4700
Mailing Address - Country:US
Mailing Address - Phone:626-289-9478
Mailing Address - Fax:626-289-9718
Practice Address - Street 1:880 S ATLANTIC BLVD STE 208
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-4700
Practice Address - Country:US
Practice Address - Phone:626-289-9478
Practice Address - Fax:626-289-9718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X
CA20A6968261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty