MEDICARE: DR. RICK CHIEN CHI TSAY D.M.D, 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	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	A91464	CA

General Provider Information

NPI Number	:	1851392062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICK CHIEN CHI TSAY D.M.D, M.D.

Provider Business Mailing Address
First Line	:	10811 ASHTON AVE
Second Line	:	#308
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-4878
Country	:	US
Telephone Number	:	310-446-1368
Fax Number	:

Provider Business Practice Location Address
First Line	:	10811 ASHTON AVE
Second Line	:	#308
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-4878
Country	:	US
Telephone Number	:	310-446-1368
Fax Number	:

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	07/08/2007

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