Healthcare Provider Details

I. General information

NPI: 1508272022
Provider Name (Legal Business Name): ANGELA HSU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2014
Last Update Date: 07/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1432 WATER LILY DR UNIT 4
CHULA VISTA CA
91913-4919
US

IV. Provider business mailing address

1432 WATER LILY DR UNIT 4
CHULA VISTA CA
91913-4919
US

V. Phone/Fax

Practice location:
  • Phone: 626-274-7567
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: