Healthcare Provider Details

I. General information

NPI: 1073056008
Provider Name (Legal Business Name): HENG HSU PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MIKE HSU PHARM.D.

II. Dates (important events)

Enumeration Date: 11/22/2016
Last Update Date: 11/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 W 7TH ST
LOS ANGELES CA
90014-1834
US

IV. Provider business mailing address

210 W 7TH ST
LOS ANGELES CA
90014-1834
US

V. Phone/Fax

Practice location:
  • Phone: 213-327-0062
  • Fax:
Mailing address:
  • Phone: 213-327-0062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number73204
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: