Provider Demographics
NPI:1265438113
Name:TSAI, LONGWAY (MD)
Entity type:Individual
Prefix:DR
First Name:LONGWAY
Middle Name:
Last Name:TSAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12225 SOUTH ST
Mailing Address - Street 2:STE 101
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-7046
Mailing Address - Country:US
Mailing Address - Phone:562-865-4141
Mailing Address - Fax:562-865-6621
Practice Address - Street 1:12225 SOUTH ST
Practice Address - Street 2:STE 101
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-7046
Practice Address - Country:US
Practice Address - Phone:562-865-4141
Practice Address - Fax:562-865-6621
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34395208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A343950Medicaid
CAA34395Medicare ID - Type Unspecified
B50252Medicare UPIN