MEDICARE: THOMAS KONG YU HSU MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	A036335	CA

General Provider Information

NPI Number	:	1942428099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS KONG YU HSU MD

Provider Business Mailing Address
First Line	:	1015 NOGALES ST STE 101
Second Line	:
City	:	ROWLAND HEIGHTS
State	:	CA
Zip	:	91748-1309
Country	:	US
Telephone Number	:	626-965-3963
Fax Number	:	626-965-4143

Provider Business Practice Location Address
First Line	:	1015 NOGALES ST STE 101
Second Line	:
City	:	ROWLAND HEIGHTS
State	:	CA
Zip	:	91748-1309
Country	:	US
Telephone Number	:	626-965-3963
Fax Number	:	626-965-4143

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	07/08/2007

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