Provider Demographics
NPI:1548294101
Name:TSAI, TONY (MD)
Entity type:Individual
Prefix:DR
First Name:TONY
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 1:3939 J ST STE 104
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-3631
Mailing Address - Country:US
Mailing Address - Phone:916-454-4861
Mailing Address - Fax:916-454-3603
Practice Address - Street 1:3939 J ST STE 106
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-3631
Practice Address - Country:US
Practice Address - Phone:916-454-4861
Practice Address - Fax:916-454-3603
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2017-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA96629207W00000X, 207WX0107X
MDD0061183207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00457114OtherRAILROAD MEDICARE
CA00A966291OtherBLUE SHIELD CA
CA00A966291Medicaid
CA00A966291Medicare PIN
CA00A966293Medicare PIN
CA00A966294Medicare PIN
CAP00457114OtherRAILROAD MEDICARE
CA00A966297Medicare PIN
CA00A966291OtherBLUE SHIELD CA
MDI04983Medicare UPIN
CA00A966295Medicare PIN