Provider Demographics
NPI:1780040477
Name:TJ TSAY MD
Entity Type:Organization
Organization Name:TJ TSAY MD
Other - Org Name:AGELESS MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TJ
Authorized Official - Middle Name:J
Authorized Official - Last Name:TSAY
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:714-760-9918
Mailing Address - Street 1:13132 NEWPORT AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3429
Mailing Address - Country:US
Mailing Address - Phone:714-760-9918
Mailing Address - Fax:
Practice Address - Street 1:13132 NEWPORT AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3429
Practice Address - Country:US
Practice Address - Phone:714-760-9918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-11
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty