Healthcare Provider Details

I. General information

NPI: 1356567572
Provider Name (Legal Business Name): EDWARD HSU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 09/08/2022
Certification Date: 09/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1014 SIMPLICITY
IRVINE CA
92620-2875
US

IV. Provider business mailing address

1014 SIMPLICITY
IRVINE CA
92620-2875
US

V. Phone/Fax

Practice location:
  • Phone: 949-336-8962
  • Fax: 888-779-7982
Mailing address:
  • Phone: 949-336-8962
  • Fax: 888-779-7982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA90100
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: