MEDICARE: MAI LY TSAI O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	1719	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477792398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAI LY TSAI O.D.

Provider Business Mailing Address
First Line	:	5979 E GRANT RD STE 107
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-2368
Country	:	US
Telephone Number	:	520-535-2588
Fax Number	:	520-535-2555

Provider Business Practice Location Address
First Line	:	5979 E GRANT RD STE 107
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-2368
Country	:	US
Telephone Number	:	520-989-1166
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2009
Last Update Date	:	04/03/2025

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