Provider Demographics
NPI:1053371559
Name:TSENG, ROBERT RA NIEN (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:RA NIEN
Last Name:TSENG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1498 SOUTHGATE AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015
Mailing Address - Country:US
Mailing Address - Phone:650-755-4492
Mailing Address - Fax:650-755-4466
Practice Address - Street 1:1498 SOUTHGATE AVE
Practice Address - Street 2:STE 102
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015
Practice Address - Country:US
Practice Address - Phone:650-755-4492
Practice Address - Fax:650-755-4466
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2012-12-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA66496207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A664960Medicaid
CA00A664961OtherBLUE SHIELD
CA00A664960Medicaid
H17882Medicare UPIN
CA00A664961Medicare ID - Type Unspecified