Provider Demographics
NPI:1679918304
Name:TSANG, STELLA KAI YAN
Entity type:Individual
Prefix:MISS
First Name:STELLA
Middle Name:KAI YAN
Last Name:TSANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 CRAVEN ROAD
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069
Mailing Address - Country:US
Mailing Address - Phone:760-510-5336
Mailing Address - Fax:
Practice Address - Street 1:400 CRAVEN ROAD
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069
Practice Address - Country:US
Practice Address - Phone:760-510-5336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-08
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71966183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician