Healthcare Provider Details

I. General information

NPI: 1205154218
Provider Name (Legal Business Name): BRYON WEICHUNG TSENG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2010
Last Update Date: 11/04/2021
Certification Date: 11/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 N LAKEVIEW AVE
ANAHEIM CA
92807-3028
US

IV. Provider business mailing address

411 N LAKEVIEW AVE
ANAHEIM CA
92807-3028
US

V. Phone/Fax

Practice location:
  • Phone: 888-988-2800
  • Fax: 888-988-2800
Mailing address:
  • Phone: 888-988-2800
  • Fax: 888-988-2800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberA124716
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: