Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | A70444 | CA |
NPI | 1053301200 |
---|---|
Provider Name | Mr. Eugene Wayne Tsai |
First Address | Artesia, CA 90701-7053 |
Second Address | Artesia, CA 90701-7053 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2005 |
Last Update Date | 07/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I02896 | (02) |