MEDICARE: HENRY TSENG DPM, INC.

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	213E00000X	Podiatrist	E4127	CA

General Provider Information

NPI Number	:	1669655031
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HENRY TSENG DPM, INC.

Provider Business Mailing Address
First Line	:	2707 E VALLEY BLVD STE 303
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91792-3198
Country	:	US
Telephone Number	:	626-330-4866
Fax Number	:	626-330-7989

Provider Business Practice Location Address
First Line	:	2707 E VALLEY BLVD STE 303
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91792-3198
Country	:	US
Telephone Number	:	626-330-4866
Fax Number	:	626-330-7989

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. HENRY RICK TSENG
Credential	:	D.P.M.
Telephone Number	:	626-330-4866

Provider Enumeration Date	:	12/08/2007
Last Update Date	:	09/15/2020

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