Provider Demographics
NPI:1699906826
Name:TSAI, JULIET (OD)
Entity type:Individual
Prefix:MS
First Name:JULIET
Middle Name:
Last Name:TSAI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 W DUARTE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-6930
Mailing Address - Country:US
Mailing Address - Phone:626-446-6300
Mailing Address - Fax:626-446-6301
Practice Address - Street 1:1 W DUARTE RD
Practice Address - Street 2:SUITE B
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-6930
Practice Address - Country:US
Practice Address - Phone:626-446-6300
Practice Address - Fax:626-446-6301
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-05
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13744152W00000X
HI702152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEO253ZMedicare PIN