Healthcare Provider Details

I. General information

NPI: 1750169090
Provider Name (Legal Business Name): DR. TJ SYIAU MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2023
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 SUNSET BLVD
ARCADIA CA
91007-6319
US

IV. Provider business mailing address

601 SUNSET BLVD
ARCADIA CA
91007-6319
US

V. Phone/Fax

Practice location:
  • Phone: 626-631-0389
  • Fax:
Mailing address:
  • Phone: 626-631-0389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: SOPHIA CHAN
Title or Position: MANGER
Credential:
Phone: 626-361-0389