Provider Demographics
NPI:1992897946
Name:PAUL C. TSAI M.D. & DOLORES O. TAN INC.
Entity type:Organization
Organization Name:PAUL C. TSAI M.D. & DOLORES O. TAN INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:C
Authorized Official - Last Name:TSAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-383-1343
Mailing Address - Street 1:700 W OLIVE AVE STE D
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-2435
Mailing Address - Country:US
Mailing Address - Phone:209-383-5291
Mailing Address - Fax:
Practice Address - Street 1:700 W OLIVE AVE STE D
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-2435
Practice Address - Country:US
Practice Address - Phone:209-383-5291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA33774207V00000X
CAA34561208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A337740Medicaid
CA00A345610Medicaid
CA00A337740Medicare ID - Type UnspecifiedPROVIDER NUMBER