Healthcare Provider Details

I. General information

NPI: 1497100606
Provider Name (Legal Business Name): GEOFFREY YUK FUNG TSOI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2016
Last Update Date: 01/26/2021
Certification Date: 01/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5581 ALTON PKWY
IRVINE CA
92618-4056
US

IV. Provider business mailing address

5581 ALTON PKWY
IRVINE CA
92618-4056
US

V. Phone/Fax

Practice location:
  • Phone: 949-453-4308
  • Fax: 949-453-4328
Mailing address:
  • Phone: 949-453-4308
  • Fax: 949-453-4328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A17304
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: