Healthcare Provider Details

I. General information

NPI: 1104187525
Provider Name (Legal Business Name): CHRISTOPHER W TSANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2012
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8280 WILLOW OAKS CORPORATE DR STE 300
FAIRFAX VA
22031-4526
US

IV. Provider business mailing address

6845 ELM ST STE 303
MC LEAN VA
22101-3834
US

V. Phone/Fax

Practice location:
  • Phone: 571-472-4300
  • Fax:
Mailing address:
  • Phone: 703-448-0005
  • Fax: 703-448-0008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number252502
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number0101264569
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: