Healthcare Provider Details

I. General information

NPI: 1740735547
Provider Name (Legal Business Name): DR. PETER TSAI ACUPUNCURE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2016
Last Update Date: 08/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 E CARSON ST STE J
CARSON CA
90745-7712
US

IV. Provider business mailing address

441 E CARSON ST STE J
CARSON CA
90745-7712
US

V. Phone/Fax

Practice location:
  • Phone: 310-830-1766
  • Fax: 310-830-1786
Mailing address:
  • Phone: 310-830-1766
  • Fax: 310-830-1786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC5433
License Number StateCA

VIII. Authorized Official

Name: CRYSTA RICHTER
Title or Position: MEDICAL BILLER
Credential:
Phone: 310-830-1766