Provider Demographics
NPI:1760583074
Name:TSAI & TSAI OD'S, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:TSAI & TSAI OD'S, A PROFESSIONAL CORPORATION
Other - Org Name:HUNTINGTON BEACH OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHILAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TSAI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:714-840-2020
Mailing Address - Street 1:5890 EDINGER AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-1705
Mailing Address - Country:US
Mailing Address - Phone:714-840-2020
Mailing Address - Fax:714-840-2025
Practice Address - Street 1:5890 EDINGER AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-1705
Practice Address - Country:US
Practice Address - Phone:714-840-2020
Practice Address - Fax:714-840-2025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACOR 960152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ09926ZOtherBLUE SHIELD GROUP PPIN
CAZZZ09926ZOtherBLUE SHIELD GROUP PPIN
CAY16365Medicare UPIN