MEDICARE: DEREK YU HSU M.D.

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	A140476	CA

General Provider Information

NPI Number	:	1952720013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEREK YU HSU M.D.

Provider Business Mailing Address
First Line	:	630 MEYER LN UNIT A
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-5262
Country	:	US
Telephone Number	:	805-338-0524
Fax Number	:

Provider Business Practice Location Address
First Line	:	338 N WESTERN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-2602
Country	:	US
Telephone Number	:	805-338-0524
Fax Number	:

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

Provider Enumeration Date	:	04/15/2014
Last Update Date	:	07/08/2024

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