Healthcare Provider Details

I. General information

NPI: 1124070180
Provider Name (Legal Business Name): MIKE HSU DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 06/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 W. 8TH ST. SUITE 101
HANFORD CA
93230-4533
US

IV. Provider business mailing address

305 EAST CENTER AVE.
VISALIA CA
93291-6331
US

V. Phone/Fax

Practice location:
  • Phone: 559-587-4532
  • Fax: 559-589-1867
Mailing address:
  • Phone: 559-737-4700
  • Fax: 559-737-4782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number54264
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: