Provider Demographics
NPI:1972852440
Name:TSAI, THOMAS (PT)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:TSAI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7805 LAGUNA BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7952
Mailing Address - Country:US
Mailing Address - Phone:916-691-5400
Mailing Address - Fax:916-691-5427
Practice Address - Street 1:7805 LAGUNA BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-7952
Practice Address - Country:US
Practice Address - Phone:916-691-5400
Practice Address - Fax:916-691-5427
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT39372225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist