Provider Demographics
NPI:1821101767
Name:TSAO, CECILLIA (MD)
Entity Type:Individual
Prefix:
First Name:CECILLIA
Middle Name:
Last Name:TSAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 VARNUM ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2180
Mailing Address - Country:US
Mailing Address - Phone:202-854-4069
Mailing Address - Fax:202-854-7825
Practice Address - Street 1:128 M ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-1205
Practice Address - Country:US
Practice Address - Phone:202-854-3840
Practice Address - Fax:202-854-3854
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD034412207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC035300800Medicaid
DCP00431121OtherMEDICARE RAILROAD
MD410695400Medicaid
DCP00431121OtherMEDICARE RAILROAD
DCE69080Medicare UPIN