Healthcare Provider Details
I. General information
NPI: 1134484850
Provider Name (Legal Business Name): YU-TZU TSENG M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/09/2012
Last Update Date: 10/24/2022
Certification Date: 10/24/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
710 LAWRENCE EXPY
SANTA CLARA CA
95051-5173
US
IV. Provider business mailing address
85 BETTENCOURT WAY
MILPITAS CA
95035-4141
US
V. Phone/Fax
- Phone: 408-554-9810
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 283774-1 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | A137132 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: