Organization Active NPI

Emerald Seinmaya Tay M D a Professional Corporation

  • Medical Specialty Clinic/Center
  • San Gabriel, CA
National Provider Identifier
1023143344
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
A72223 Issued in CA
Legal business name
EMERALD SEINMAYA TAY M D A PROFESSIONAL CORPORATION
Practice address
222 E Valley Blvd
San Gabriel, CA 91776-3596
Phone
(626) 307-8636
Fax
(626) 307-8705
NPI assigned
Feb 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Emerald Tay, M.DNPI 1255331294
Title
President
Phone
(626) 307-8636

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X A72223 CA Primary

Addresses

Primary practice location

222 E Valley Blvd
San Gabriel, CA 91776-3596

Mailing address

222 E Valley Blvd
San Gabriel, CA 91776-3596
Phone (626) 307-8636

Other identifiers 1

IdentifierTypeStateIssuer
00A722230MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050720001087 CA Part B Supplier - Clinic/Group Practice 1658308705 Receives reassigned benefits from 2 practitioners
Practice locations: San Gabriel, CA

National Provider Directory

National Provider Directory

Locations

9129 Valley Blvd
Rosemead, CA 91770
Phone (626) 292-7163

222 E Valley Blvd
San Gabriel, CA 91776
Phone (626) 307-8636

828 E Valley Blvd
Ste C
San Gabriel, CA 91776
Phone (626) 307-8636

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277769600000",
    "number": "1023143344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E VALLEY BLVD",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763596",
            "telephone_number": "626-307-8636",
            "fax_number": "626-307-8705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E VALLEY BLVD",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917763596",
            "telephone_number": "626-307-8636",
            "fax_number": "626-307-8705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD SEINMAYA TAY M D A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2010-06-29",
        "status": "A",
        "authorized_official_last_name": "TAY",
        "authorized_official_first_name": "EMERALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-307-8636",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "A72223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A722230",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.