MEDICARE: ALBERT TAI

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1255070603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALBERT TAI

Provider Business Mailing Address
First Line	:	2342 DOUBLETREE LN
Second Line	:
City	:	ROWLAND HEIGHTS
State	:	CA
Zip	:	91748-4613
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 S VINCENT AVE STE 200
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91790-6712
Country	:	US
Telephone Number	:	626-727-6688
Fax Number	:

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

Provider Enumeration Date	:	06/02/2022
Last Update Date	:	11/08/2022

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Directions to “ ALBERT TAI ” Practice Location

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