Healthcare Provider Details

I. General information

NPI: 1154514057
Provider Name (Legal Business Name): PETER C TSAI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2007
Last Update Date: 01/12/2021
Certification Date: 01/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2773 NW 9TH ST
CORVALLIS OR
97330-3857
US

IV. Provider business mailing address

2773 NW 9TH ST
CORVALLIS OR
97330-3857
US

V. Phone/Fax

Practice location:
  • Phone: 541-207-0910
  • Fax: 541-738-2596
Mailing address:
  • Phone: 541-207-0910
  • Fax: 541-738-2596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberMD29406
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD29406
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: