Provider Demographics
NPI:1780155580
Name:PHILLIP TSE, MD MEDICAL CORPORATION
Entity type:Organization
Organization Name:PHILLIP TSE, MD MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:TSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-373-6798
Mailing Address - Street 1:373 S REDWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-5109
Mailing Address - Country:US
Mailing Address - Phone:408-261-3739
Mailing Address - Fax:408-261-3737
Practice Address - Street 1:373 S REDWOOD AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-5109
Practice Address - Country:US
Practice Address - Phone:408-261-3739
Practice Address - Fax:408-261-3737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-06
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty