Provider Demographics
NPI:1629006044
Name:TSAI, CHARLIS (L AC)
Entity Type:Individual
Prefix:DR
First Name:CHARLIS
Middle Name:
Last Name:TSAI
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1042 S SAN GABRIEL BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-3113
Mailing Address - Country:US
Mailing Address - Phone:626-287-3512
Mailing Address - Fax:626-287-4210
Practice Address - Street 1:1042 S SAN GABRIEL BLVD
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-3113
Practice Address - Country:US
Practice Address - Phone:626-287-3512
Practice Address - Fax:626-287-4210
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC1616171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist