Healthcare Provider Details

I. General information

NPI: 1992897946
Provider Name (Legal Business Name): PAUL C. TSAI M.D. & DOLORES O. TAN INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W OLIVE AVE STE D
MERCED CA
95348-2435
US

IV. Provider business mailing address

700 W OLIVE AVE STE D
MERCED CA
95348-2435
US

V. Phone/Fax

Practice location:
  • Phone: 209-383-5291
  • Fax:
Mailing address:
  • Phone: 209-383-5291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA33774
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA34561
License Number StateCA

VIII. Authorized Official

Name: DR. PAUL C TSAI
Title or Position: DOCTOR
Credential: M.D.
Phone: 209-383-1343