Healthcare Provider Details

I. General information

NPI: 1457344483
Provider Name (Legal Business Name): CHRISTOPHER K TSAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 05/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 E ARROW HWY SUITE E
UPLAND CA
91786-5525
US

IV. Provider business mailing address

1175 E ARROW HWY SUITE E
UPLAND CA
91786-5525
US

V. Phone/Fax

Practice location:
  • Phone: 909-985-9737
  • Fax: 909-981-1203
Mailing address:
  • Phone: 909-985-9737
  • Fax: 909-981-1203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberA54843
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: