Healthcare Provider Details

I. General information

NPI: 1205903135
Provider Name (Legal Business Name): DENNIS MING KANG HSUEH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 11/18/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25825 VERMONT AVE
HARBOR CITY CA
90710-3518
US

IV. Provider business mailing address

25825 VERMONT AVE
HARBOR CITY CA
90710-3518
US

V. Phone/Fax

Practice location:
  • Phone: 310-325-5111
  • Fax:
Mailing address:
  • Phone: 310-325-5111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberA85679
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: