Provider Demographics
NPI:1497933998
Name:TSAO, RAYMOND ERIC (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:ERIC
Last Name:TSAO
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 1:1630 S CONGRESS AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-2171
Mailing Address - Country:US
Mailing Address - Phone:561-253-3980
Mailing Address - Fax:877-864-7231
Practice Address - Street 1:1630 S CONGRESS AVE STE 200
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-2171
Practice Address - Country:US
Practice Address - Phone:561-253-3980
Practice Address - Fax:561-253-3985
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.009739207RH0003X
NC2008-00990207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5909876Medicaid
SCN00990Medicaid
NC5909876Medicaid