Provider Demographics
NPI:1609820646
Name:TSAO, DENIS W (MD)
Entity Type:Individual
Prefix:MR
First Name:DENIS
Middle Name:W
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:PO BOX 7096
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95267
Mailing Address - Country:US
Mailing Address - Phone:209-956-7725
Mailing Address - Fax:209-956-7733
Practice Address - Street 1:1801 COLORADO AVE
Practice Address - Street 2:#140
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-2706
Practice Address - Country:US
Practice Address - Phone:209-656-8771
Practice Address - Fax:209-216-3475
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG33742207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G337420Medicaid
A45664Medicare UPIN
CAAX014Medicare PIN
CA00G337420Medicaid
CA00G337422Medicare PIN
CA00G337423Medicare PIN
CAAY481YMedicare PIN