Provider Demographics
NPI:1740395417
Name:TSOI, DAN WINGHAY (MD)
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:WINGHAY
Last Name:TSOI
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 7132
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95604-7132
Mailing Address - Country:US
Mailing Address - Phone:530-889-6336
Mailing Address - Fax:530-889-8285
Practice Address - Street 1:3257 PROFESSIONAL DR
Practice Address - Street 2:SUITE C
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95602-2460
Practice Address - Country:US
Practice Address - Phone:530-889-6336
Practice Address - Fax:530-889-8285
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40951207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1740395417Medicaid
CAEM767ZMedicare PIN