Provider Demographics
NPI:1851462055
Name:TSAI, TSUONG WU (MD)
Entity Type:Individual
Prefix:
First Name:TSUONG
Middle Name:WU
Last Name:TSAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3581 PALMER DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CAMERON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:95682-8236
Mailing Address - Country:US
Mailing Address - Phone:530-676-6600
Mailing Address - Fax:
Practice Address - Street 1:3581 PALMER DR
Practice Address - Street 2:SUITE 202
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682-8236
Practice Address - Country:US
Practice Address - Phone:530-676-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA51644207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF67365Medicaid
CAF67365Medicaid
CAA51644Medicare UPIN