Provider Demographics
NPI:1013173871
Name:TSAO, CHIA-LUN (DDS)
Entity type:Individual
Prefix:DR
First Name:CHIA-LUN
Middle Name:
Last Name:TSAO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12941 SCARBOROUGH LN
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-7260
Mailing Address - Country:US
Mailing Address - Phone:562-688-4997
Mailing Address - Fax:
Practice Address - Street 1:10600 KATELLA AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-6607
Practice Address - Country:US
Practice Address - Phone:714-758-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA573351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice