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General NPI Number Information
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NPI Number | 1518857069
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Entity Type | Individual
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Provider Name | MICHAEL TSANG DMD, MA
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Gender | Male
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Dates
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Enumeration Date | 07/07/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 224 E BASE LINE RD
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City | RIALTO
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State | CA
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Zip | 92376-3506
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Country | US
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Telephone | 909-874-4699
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Fax |
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Provider Business Mailing Address
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Address Line | 5925 SYCAMORE CANYON BLVD APT 216
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City | RIVERSIDE
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State | CA
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Zip | 92507-8471
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Country | US
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Telephone | 773-710-1053
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 111910
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License Number State | CA
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