MEDICARE: SOFIA GONZALEZ-TSAI DOCTOR OF PHARMACY

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	010557	AZ

General Provider Information

NPI Number	:	1770818635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOFIA GONZALEZ-TSAI DOCTOR OF PHARMACY

Provider Business Mailing Address
First Line	:	6601 W INDIAN SCHOOL RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85033-3339
Country	:	US
Telephone Number	:	623-846-1533
Fax Number	:	623-846-6403

Provider Business Practice Location Address
First Line	:	6601 W INDIAN SCHOOL RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85033-3339
Country	:	US
Telephone Number	:	623-846-1533
Fax Number	:	623-846-6403

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

Provider Enumeration Date	:	10/12/2009
Last Update Date	:	10/12/2009

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