Provider Demographics
NPI:1609098771
Name:TSAI-LI, JOY (MD)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:TSAI-LI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13103 IRELAND LN
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2379
Mailing Address - Country:US
Mailing Address - Phone:773-343-2365
Mailing Address - Fax:
Practice Address - Street 1:510 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020
Practice Address - Country:US
Practice Address - Phone:619-440-1211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036127462208100000X
CA159708C208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036127462Medicaid
ILP01388015OtherRR MEDICARE
IL036127462OtherLICENSE NO
IL036127462Medicaid