Healthcare Provider Details

I. General information

NPI: 1033821194
Provider Name (Legal Business Name): HANNA HSU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2022
Last Update Date: 12/21/2022
Certification Date: 12/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 S AZUSA AVE STE 101
HACIENDA HEIGHTS CA
91745-6854
US

IV. Provider business mailing address

20667 KELFIELD DR
DIAMOND BAR CA
91789-3857
US

V. Phone/Fax

Practice location:
  • Phone: 626-912-3311
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number85707
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: