Provider Demographics
NPI:1841372398
Name:AMBROSE Y TSANG MD INC
Entity type:Organization
Organization Name:AMBROSE Y TSANG MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMBROSE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:TSANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-862-0804
Mailing Address - Street 1:11480 BROOKSHIRE AVE
Mailing Address - Street 2:STE 302
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-5018
Mailing Address - Country:US
Mailing Address - Phone:562-862-0804
Mailing Address - Fax:562-862-8184
Practice Address - Street 1:11480 BROOKSHIRE AVE
Practice Address - Street 2:STE 302
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-5018
Practice Address - Country:US
Practice Address - Phone:562-862-0804
Practice Address - Fax:562-862-8184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG28688174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G286880Medicaid
CAA43825Medicare UPIN
CA00G286880Medicaid