Provider Demographics
NPI:1710261268
Name:TSAI, JEFF
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:TSAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3580 COTTER RIM LN
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-3762
Mailing Address - Country:US
Mailing Address - Phone:909-289-9898
Mailing Address - Fax:
Practice Address - Street 1:17595 ALMAHURST ST STE 230
Practice Address - Street 2:SUITE # 230
Practice Address - City:CITY OF INDUSTRY
Practice Address - State:CA
Practice Address - Zip Code:91748-1799
Practice Address - Country:US
Practice Address - Phone:626-839-5697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4669171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist