Basic Information
| Provider Information | |||||||||
| NPI: | 1396141537 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TSAI | ||||||||
| FirstName: | SHUN-JU | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4061 W 138TH ST APT 29 | ||||||||
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| City: | HAWTHORNE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902501104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2138148659 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8717 VENICE BLVD | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900343216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103377115 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2014 | ||||||||
| LastUpdateDate: | 11/17/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 14080 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.