Healthcare Provider Details

I. General information

NPI: 1720782865
Provider Name (Legal Business Name): WHITNEY TSE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2023
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1975 4TH ST
SAN FRANCISCO CA
94143-2351
US

IV. Provider business mailing address

747 52ND ST STE 245
OAKLAND CA
94609-1809
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-5153
  • Fax: 415-476-5354
Mailing address:
  • Phone: 510-428-3331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA208214
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberA208214
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: