Healthcare Provider Details

I. General information

NPI: 1497910129
Provider Name (Legal Business Name): DR THOMAS TSENG MEDICAL CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2008
Last Update Date: 08/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 S ATLANTIC BLVD STE 208
MONTEREY PARK CA
91754-4700
US

IV. Provider business mailing address

880 S ATLANTIC BLVD STE 208
MONTEREY PARK CA
91754-4700
US

V. Phone/Fax

Practice location:
  • Phone: 626-289-9478
  • Fax: 626-289-9718
Mailing address:
  • Phone: 626-289-9478
  • Fax: 626-289-9718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number20A6968
License Number StateCA

VIII. Authorized Official

Name: DR. THOMAS MU-REN TSENG
Title or Position: PRESIDENT
Credential: D.O.
Phone: 626-289-9478