Healthcare Provider Details

I. General information

NPI: 1225665391
Provider Name (Legal Business Name): KEVIN HSU DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11500 BROOKSHIRE AVE
DOWNEY CA
90241-4917
US

IV. Provider business mailing address

5 WILLIAMS
IRVINE CA
92620-3381
US

V. Phone/Fax

Practice location:
  • Phone: 562-904-5000
  • Fax: 562-904-5140
Mailing address:
  • Phone: 562-565-7891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A20503
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: