Healthcare Provider Details

I. General information

NPI: 1144470667
Provider Name (Legal Business Name): AMY K HSU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2008
Last Update Date: 05/23/2022
Certification Date: 05/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9440 SANTA MONICA BLVD STE 408
BEVERLY HILLS CA
90210-4610
US

IV. Provider business mailing address

9440 SANTA MONICA BLVD STE 408
BEVERLY HILLS CA
90210-4610
US

V. Phone/Fax

Practice location:
  • Phone: 310-800-2371
  • Fax: 877-991-4918
Mailing address:
  • Phone: 310-800-2371
  • Fax: 877-991-4918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number246372
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License NumberA120839
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: