Healthcare Provider Details

I. General information

NPI: 1982122958
Provider Name (Legal Business Name): KAREN HSU ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MAVERICK WAY
CARLSBAD CA
92009-8957
US

IV. Provider business mailing address

8588 VILLA LA JOLLA DR APT 367
LA JOLLA CA
92037-2344
US

V. Phone/Fax

Practice location:
  • Phone: 760-436-6136
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: