Provider Demographics
NPI:1558580928
Name:TSAI, ANGELA F (LAC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:F
Last Name:TSAI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:CHUN-CHIN
Other - Middle Name:FANG
Other - Last Name:TSAI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:861 SAN BRUNO AVE W RM 3
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-3400
Mailing Address - Country:US
Mailing Address - Phone:650-875-2378
Mailing Address - Fax:650-875-0769
Practice Address - Street 1:861 SAN BRUNO AVE W RM 3
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-3400
Practice Address - Country:US
Practice Address - Phone:650-875-2378
Practice Address - Fax:650-875-0769
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5113171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist