Healthcare Provider Details

I. General information

NPI: 1649520701
Provider Name (Legal Business Name): DENNIS HSIEH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2012
Last Update Date: 06/04/2020
Certification Date: 06/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 E 31ST ST C/O AUANJA THOMPSON, DEPARTMENT OF EMERGENCY MEDICINE
OAKLAND CA
94602-1018
US

IV. Provider business mailing address

3264 MARKET ST
SAN FRANCISCO CA
94114-2227
US

V. Phone/Fax

Practice location:
  • Phone: 857-998-0024
  • Fax:
Mailing address:
  • Phone: 857-998-0024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA129373
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberA129373
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: