MEDICARE: OLIVER C TSAI M.D.

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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	A49033	CA

General Provider Information

NPI Number	:	1306828272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLIVER C TSAI M.D.

Provider Business Mailing Address
First Line	:	1433 W MERCED AVE
Second Line	:	SUITE 308
City	:	WEST COVINA
State	:	CA
Zip	:	91790-3402
Country	:	US
Telephone Number	:	626-962-3584
Fax Number	:	626-962-3261

Provider Business Practice Location Address
First Line	:	1433 W MERCED AVE
Second Line	:	SUITE 308
City	:	WEST COVINA
State	:	CA
Zip	:	91790-3402
Country	:	US
Telephone Number	:	626-962-3584
Fax Number	:	626-962-3261

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

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	07/08/2007

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