Healthcare Provider Details

I. General information

NPI: 1073953121
Provider Name (Legal Business Name): CHING KUNG HSU L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ANDREW C. HSU L.AC.

II. Dates (important events)

Enumeration Date: 07/02/2013
Last Update Date: 07/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4469 REDONDO BEACH BLVD
LAWNDALE CA
90260-3465
US

IV. Provider business mailing address

416 W LAS TUNAS DR STE#305
SAN GABRIEL CA
91776-1236
US

V. Phone/Fax

Practice location:
  • Phone: 626-512-1505
  • Fax:
Mailing address:
  • Phone: 626-512-1505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC14780
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: