=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063523884
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TAL INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/31/2006
-----------------------------------------------------
Last Update Date | 07/24/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13768 ROSWELL AVE SUITE 111
-----------------------------------------------------
City | CHINO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91710-1401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-548-6186
-----------------------------------------------------
Fax | 909-590-3933
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13768 ROSWELL AVE SUITE 111
-----------------------------------------------------
City | CHINO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91710-1401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-548-6186
-----------------------------------------------------
Fax | 909-590-3933
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | TERENCE C TSE
-----------------------------------------------------
Credential | PHARM.D.
-----------------------------------------------------
Telephone | 909-548-6186
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------