Individual provider Active NPI

Chin Luan Tsai

  • Pediatrics Physician
  • Loma Linda, CA
National Provider Identifier
1487237624
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20A22306 Issued in CA
Practice address
Loma Linda University Health - Pediatrics, General
11234 Anderson Street
Loma Linda, CA 92354-2804
Phone
(909) 558-4174
NPI assigned
May 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 20A22306 CA Primary

Addresses

Primary practice location

Loma Linda University Health - Pediatrics, General
11234 Anderson Street
Loma Linda, CA 92354-2804

Mailing address

11234 Anderson Street, Gme Office Westerly Suite 'C'
Loma Linda, CA 92354-2804

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240621000847 CA Practitioner - Pediatric Medicine 8820531627 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22306CAMDCase Manager/Care Coordinator
20A22306CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sac Health System CurrentSince Jul 1, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jul 1, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Sac Health System Current Accepting new patients
Sac Health System CurrentSince Jul 1, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients

Locations

82934 Civic Center Dr
Indio, CA 92201
Phone (760) 477-0733

11234 Anderson St
Ofc
Loma Linda, CA 92350
Phone (909) 558-4074

11370 Anderson St
Ste 2600
Loma Linda, CA 92354
Phone (909) 558-2890

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

250 S G St
San Bernardino, CA 92410
Phone (909) 771-2990

1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146

Interoperability endpoints

  • Direct secure messaging: ctsai373128@direct.llu.edu

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1487237624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON STREET, GME OFFICE WESTERLY SUITE 'C'",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LOMA LINDA UNIVERSITY HEALTH - PEDIATRICS, GENERAL",
            "address_2": "11234 ANDERSON STREET",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSAI",
        "first_name": "CHIN",
        "middle_name": "LUAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-05",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A22306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.