Healthcare Provider Details

I. General information

NPI: 1497979629
Provider Name (Legal Business Name): KENNETH K HSU M.D., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 W COLUMBUS ST
BAKERSFIELD CA
93301-1201
US

IV. Provider business mailing address

PO BOX 20633
BAKERSFIELD CA
93390-0633
US

V. Phone/Fax

Practice location:
  • Phone: 661-322-2329
  • Fax:
Mailing address:
  • Phone: 661-322-2329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberA505770
License Number StateCA

VIII. Authorized Official

Name: KENNETH HSU
Title or Position: OWNER
Credential: M.D.
Phone: 661-322-2329