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NPI Code Detail

MEDICARE: TONIA KIM TSE

MEDICARE:   TONIA KIM 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
11041C0700XClinical Social WorkerLCS 24178CA

General Provider Information

NPI Number : 1417086273
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONIA KIM TSE
Provider Business Mailing Address
First Line : 3300 FOOTHILL BLVD.
Second Line : PO BOX 8283
City : LA CRESCENTA
State : CA
Zip : 91214
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4445 EASTGATE MALL STE 200
Second Line :
City : SAN DIEGO
State : CA
Zip : 92121-1979
Country : US
Telephone Number : 866-254-7243
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2007
Last Update Date : 06/07/2022

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