Healthcare Provider Details

I. General information

NPI: 1568425148
Provider Name (Legal Business Name): TSUNG TSUAN LI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2316 DWIGHT WAY STE 1
BERKELEY CA
94704-2212
US

IV. Provider business mailing address

2316 DWIGHT WAY STE 1
BERKELEY CA
94704-2212
US

V. Phone/Fax

Practice location:
  • Phone: 510-845-4500
  • Fax: 510-845-0360
Mailing address:
  • Phone: 510-845-4500
  • Fax: 510-845-0360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberG74650
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: