Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD29406 | OR |
N | 207XS0106X | Orthopaedic Hand Surgeon | MD29406 | OR |
NPI | 1154514057 |
---|---|
Provider Name | Peter C Tsai |
First Address | Corvallis, OR 97330-3857 |
Second Address | Corvallis, OR 97330-3857 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2007 |
Last Update Date | 12/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000281477 | HMSA BILLING NUMBER (01) | HI |
623414-01 | (05) | HI |