Provider Demographics
NPI:1013909407
Name:TSAI, ISAAC K (MD)
Entity Type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:K
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 1:341 MAGNOLIA AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-3330
Mailing Address - Country:US
Mailing Address - Phone:951-735-4771
Mailing Address - Fax:951-735-3855
Practice Address - Street 1:341 MAGNOLIA AVE.
Practice Address - Street 2:SUITE 205
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3120
Practice Address - Country:US
Practice Address - Phone:951-735-4771
Practice Address - Fax:951-735-3855
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2007-07-08
Deactivation Date:2006-03-25
Deactivation Code:
Reactivation Date:2006-04-12
Provider Licenses
StateLicense IDTaxonomies
CAA39031207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA28797Medicare UPIN
CA00A390310Medicare ID - Type Unspecified