MEDICARE: TONY TSE

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
1	183500000X	Pharmacist	45784	CA

General Provider Information

NPI Number	:	1225257207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONY TSE

Provider Business Mailing Address
First Line	:	2175 S LOS ROBLES AVE
Second Line	:
City	:	SAN MARINO
State	:	CA
Zip	:	91108-2330
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 W GARVEY AVE
Second Line	:	SUITE 107
City	:	MONTEREY PARK
State	:	CA
Zip	:	91754-7418
Country	:	US
Telephone Number	:	626-572-0800
Fax Number	:	626-572-8505

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	07/08/2007

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Directions to “ TONY TSE ” Practice Location

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