Healthcare Provider Details

I. General information

NPI: 1306977038
Provider Name (Legal Business Name): MING S HSU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 10/16/2021
Certification Date: 10/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N STATE ST ROOM D&T 3D321
LOS ANGELES CA
90033-1029
US

IV. Provider business mailing address

1200 N STATE ST ROOM D&T 3D321
LOS ANGELES CA
90033-1029
US

V. Phone/Fax

Practice location:
  • Phone: 323-409-7257
  • Fax:
Mailing address:
  • Phone: 323-409-7257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA95066
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: