Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | A93379 | CA |
NPI | 1053499558 |
---|---|
Provider Name | Yonghua Tai |
First Address | Oakland, CA 94612-3466 |
Second Address | Vallejo, CA 94589-2441 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 09/12/2021 |