Provider Demographics
NPI:1942377916
Name:TSAO, CHIALIN (MD)
Entity Type:Individual
Prefix:
First Name:CHIALIN
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 1:2710 BELROSE AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-1406
Mailing Address - Country:US
Mailing Address - Phone:510-981-1689
Mailing Address - Fax:
Practice Address - Street 1:2828 TELEGRAPH AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1119
Practice Address - Country:US
Practice Address - Phone:510-845-2888
Practice Address - Fax:510-845-2333
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49304207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F65011Medicare UPIN
CA00A493040Medicare ID - Type Unspecified