Provider Demographics
NPI:1295733855
Name:TSENG, HENRY RICK (DPM)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:RICK
Last Name:TSENG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2707 E VALLEY BLVD STE 303
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-3198
Mailing Address - Country:US
Mailing Address - Phone:626-330-4866
Mailing Address - Fax:626-330-7989
Practice Address - Street 1:2707 E VALLEY BLVD STE 303
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792-3198
Practice Address - Country:US
Practice Address - Phone:626-330-4866
Practice Address - Fax:626-330-7989
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4127213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E41270Medicare PIN