Provider Demographics
NPI:1013946110
Name:EDWARD K TSAI
Entity Type:Organization
Organization Name:EDWARD K TSAI
Other - Org Name:SIERRA FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:K
Authorized Official - Last Name:TSAI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-896-4433
Mailing Address - Street 1:7377 S JONES BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-0547
Mailing Address - Country:US
Mailing Address - Phone:702-896-4433
Mailing Address - Fax:702-896-4438
Practice Address - Street 1:7377 S JONES BLVD STE 107
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89139-0547
Practice Address - Country:US
Practice Address - Phone:702-896-4433
Practice Address - Fax:702-896-4438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1003119565207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100509002Medicaid
NV100509354Medicaid
NV100509354Medicaid