Healthcare Provider Details

I. General information

NPI: 1699456038
Provider Name (Legal Business Name): YINGHUA TSENG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2023
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 W FOOTHILL BLVD UNIT B
MONROVIA CA
91016-1971
US

IV. Provider business mailing address

910 W FOOTHILL BLVD UNIT B
MONROVIA CA
91016-1971
US

V. Phone/Fax

Practice location:
  • Phone: 626-716-1630
  • Fax:
Mailing address:
  • Phone: 626-716-1630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95116043
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95030837
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: