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General NPI Number Information
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NPI Number | 1447050034
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Entity Type | Individual
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Provider Name | JASON CHENG-JIE TSAO
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Gender |
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Dates
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Enumeration Date | 03/14/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 1081 N CHINA LAKE BLVD
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City | RIDGECREST
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State | CA
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Zip | 93555-3130
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Country | US
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Telephone | 760-446-3551
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Fax |
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Provider Business Mailing Address
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Address Line | 225 E RIDGECREST BLVD
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City | RIDGECREST
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State | CA
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Zip | 93555-3983
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Country | US
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Telephone | 415-283-8732
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 90181
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License Number State | CA
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