Provider Demographics
NPI:1831101351
Name:ROBERT SHOU JEN TSAI MD A PROFESSIONAL CORP
Entity Type:Organization
Organization Name:ROBERT SHOU JEN TSAI MD A PROFESSIONAL CORP
Other - Org Name:ROBERT S TSAI MD INC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:SHOU JEN
Authorized Official - Last Name:TSAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-529-7772
Mailing Address - Street 1:16415 S COLORADO AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-5054
Mailing Address - Country:US
Mailing Address - Phone:562-529-7772
Mailing Address - Fax:562-529-5449
Practice Address - Street 1:16415 S COLORADO AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-5054
Practice Address - Country:US
Practice Address - Phone:562-529-7772
Practice Address - Fax:562-529-5449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA33163208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty