Provider Demographics
NPI:1770652687
Name:MICKEY M.Y. TSENG, M.D., M.P.H., INC.
Entity Type:Organization
Organization Name:MICKEY M.Y. TSENG, M.D., M.P.H., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICKEY
Authorized Official - Middle Name:MY
Authorized Official - Last Name:TSENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-531-5070
Mailing Address - Street 1:PO BOX 2245
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-8245
Mailing Address - Country:US
Mailing Address - Phone:808-484-1169
Mailing Address - Fax:808-484-1168
Practice Address - Street 1:2228 LILIHA ST
Practice Address - Street 2:SUITE 101
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1650
Practice Address - Country:US
Practice Address - Phone:808-531-5070
Practice Address - Fax:808-531-5074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-10396207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI08770201Medicaid
HI51323Medicare ID - Type Unspecified
HIG79837Medicare UPIN