Healthcare Provider Details

I. General information

NPI: 1902831894
Provider Name (Legal Business Name): CHUN YEN HSU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 07/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N GARFIELD AVE #310
MONTEREY PARK CA
91754-1172
US

IV. Provider business mailing address

600 N GARFIELD AVE STE 310
MONTEREY PARK CA
91754-1172
US

V. Phone/Fax

Practice location:
  • Phone: 626-573-9979
  • Fax:
Mailing address:
  • Phone: 626-573-9979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA37929
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: