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NPI Code Detail

MEDICARE: MICHAEL TAY OD

MEDICARE: MICHAEL TAY OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist35237CA

General Provider Information

NPI Number : 1003530627
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL TAY OD
Provider Business Mailing Address
First Line : 14100 W MONROE PL
Second Line :
City : VAN NUYS
State : CA
Zip : 91405-5655
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4433 S ALAMEDA ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90058-2008
Country : US
Telephone Number : 323-988-1033
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2022
Last Update Date : 09/27/2022

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