Healthcare Provider Details

I. General information

NPI: 1558528976
Provider Name (Legal Business Name): KEVIN YEE-BIEN TSE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 11/17/2021
Certification Date: 11/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9350 CAMPUS POINT DR SUITE 2-C
LA JOLLA CA
92037-1300
US

IV. Provider business mailing address

9500 GILMAN DR MC #0635
LA JOLLA CA
92093-5004
US

V. Phone/Fax

Practice location:
  • Phone: 858-657-8440
  • Fax:
Mailing address:
  • Phone: 858-657-8440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberA109553
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: