Healthcare Provider Details

I. General information

NPI: 1780040477
Provider Name (Legal Business Name): TJ TSAY MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2016
Last Update Date: 12/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13132 NEWPORT AVE SUITE 200
TUSTIN CA
92780-3429
US

IV. Provider business mailing address

13132 NEWPORT AVE SUITE 200
TUSTIN CA
92780-3429
US

V. Phone/Fax

Practice location:
  • Phone: 714-760-9918
  • Fax:
Mailing address:
  • Phone: 714-760-9918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: TJ J TSAY
Title or Position: PRESIDENT/OWNER
Credential: M. D.
Phone: 714-760-9918