Healthcare Provider Details

I. General information

NPI: 1073047932
Provider Name (Legal Business Name): VICTORIA TSANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2017
Last Update Date: 08/05/2021
Certification Date: 06/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 E MISSOURI AVE STE 300
PHOENIX AZ
85012-1351
US

IV. Provider business mailing address

3838 N BORG LN
TUCSON AZ
85716-0828
US

V. Phone/Fax

Practice location:
  • Phone: 602-262-8917
  • Fax: 602-262-8890
Mailing address:
  • Phone: 203-536-0002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number63186
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR76023
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: