Healthcare Provider Details

I. General information

NPI: 1124472568
Provider Name (Legal Business Name): KELLY TSENG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2016
Last Update Date: 08/30/2025
Certification Date: 08/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 LINDEN AVE
LONG BEACH CA
90813-3321
US

IV. Provider business mailing address

55 FRUIT ST., GRB 444 MASSACHUSETTS GENERAL HOSPITAL
BOSTON MA
02114
US

V. Phone/Fax

Practice location:
  • Phone: 562-491-9000
  • Fax:
Mailing address:
  • Phone: 617-726-3030
  • Fax: 617-726-9697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number282446
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA172216
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA172216
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: