Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | A162583 | CA |
NPI | 1114361201 |
---|---|
Provider Name | Dr. Jeffrey Tsai |
First Address | North Hills, CA 91343-2036 |
Second Address | North Hills, CA 91343-2036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2013 |
Last Update Date | 01/11/2020 |