Healthcare Provider Details

I. General information

NPI: 1568374692
Provider Name (Legal Business Name): MARK TSUI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 ROLLINS RD
BURLINGAME CA
94010-2306
US

IV. Provider business mailing address

2761 SHERWOOD DR
SAN BRUNO CA
94066-1731
US

V. Phone/Fax

Practice location:
  • Phone: 650-642-5083
  • Fax:
Mailing address:
  • Phone: 415-596-1965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberE153775
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: