Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | G86069 | CA |
NPI | 1003811746 |
---|---|
Provider Name | Dr. Hennessey Tseng |
First Address | San Francisco, CA 94139-0001 |
Second Address | Walnut Creek, CA 94597-2168 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2005 |
Last Update Date | 11/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H40920 | (02) | CA |
P01474566 | RAILROAD MEDICARE (01) | CA |