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General NPI Number Information
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NPI Number | 1538704234
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Entity Type | Individual
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Provider Name | MICHELLE V TSAI
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Gender | Female
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Dates
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Enumeration Date | 11/17/2019
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Last Update Date | 12/06/2021
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Provider Practice Location Address
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Address Line | 2101 N WATERMAN AVE
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-4836
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Country | US
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Telephone | 909-883-8711
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Fax |
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Provider Business Mailing Address
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Address Line | 1236 PENDIO
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City | IRVINE
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State | CA
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Zip | 92620-1751
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Country | US
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Telephone | 510-386-4319
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 19913
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License Number State | CA
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