Healthcare Provider Details

I. General information

NPI: 1861812760
Provider Name (Legal Business Name): OPAL LIN-TSAI REDDY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OPAL LIN-TSAI MD

II. Dates (important events)

Enumeration Date: 04/18/2014
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10833 LE CONTE AVE
LOS ANGELES CA
90095-5331
US

IV. Provider business mailing address

5767 W CENTURY BLVD STE 400
LOS ANGELES CA
90045-5631
US

V. Phone/Fax

Practice location:
  • Phone: 310-206-0944
  • Fax:
Mailing address:
  • Phone: 310-301-8707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License NumberA141144
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: