Provider Demographics
NPI:1710193651
Name:TSENG, TOM (OD)
Entity Type:Individual
Prefix:DR
First Name:TOM
Middle Name:
Last Name:TSENG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 DONNELLY CT
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94949-7258
Mailing Address - Country:US
Mailing Address - Phone:415-531-4551
Mailing Address - Fax:
Practice Address - Street 1:3540 MENDOCINO AVE STE 200
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-3639
Practice Address - Country:US
Practice Address - Phone:707-522-6200
Practice Address - Fax:707-522-6215
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12436T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist