Healthcare Provider Details

I. General information

NPI: 1386861409
Provider Name (Legal Business Name): TINYEE TSAI CHANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TINYEE L TSAI MD

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 05/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 SMILE PLACE SUITE B
REDDING CA
96001
US

IV. Provider business mailing address

2570 GOODWATER AVE #300
REDDING CA
96002-1548
US

V. Phone/Fax

Practice location:
  • Phone: 530-221-3376
  • Fax: 530-221-3378
Mailing address:
  • Phone: 530-221-3376
  • Fax: 530-221-3378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA88191
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: