Provider Demographics
NPI:1295810729
Name:STRONG AND TAY MDS
Entity type:Organization
Organization Name:STRONG AND TAY MDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:TAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-795-8186
Mailing Address - Street 1:39233 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1501
Mailing Address - Country:US
Mailing Address - Phone:510-795-8186
Mailing Address - Fax:510-792-8186
Practice Address - Street 1:39233 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1501
Practice Address - Country:US
Practice Address - Phone:510-795-8186
Practice Address - Fax:510-792-8186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG69757174400000X
CAA68265174400000X
CAA65315174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A653150Medicaid
CA00G697570Medicaid
CAP81307Medicare UPIN
CAA65315Medicare UPIN
CA00A653150Medicaid
CA00A6353150Medicare PIN
CA00A653151Medicare UPIN
CA00G697570Medicaid
CA00A682652Medicare PIN
CA00A682650Medicare PIN
CA00G697571Medicare PIN
CA0G697571Medicare UPIN