Healthcare Provider Details

I. General information

NPI: 1992746234
Provider Name (Legal Business Name): CHRISTOPHER T. HSU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 11/22/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6041 CADILLAC AVE
LOS ANGELES CA
90034-1702
US

IV. Provider business mailing address

4060 GLENCOE AVE APT 101
MARINA DEL REY CA
90292-5881
US

V. Phone/Fax

Practice location:
  • Phone: 323-857-3309
  • Fax: 323-857-2619
Mailing address:
  • Phone: 415-828-6841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA89324
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: