Healthcare Provider Details

I. General information

NPI: 1043281934
Provider Name (Legal Business Name): VANESSA D HSU O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 05/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3612 E CHAPMAN AVE
ORANGE CA
92869-3847
US

IV. Provider business mailing address

3612 E CHAPMAN AVE
ORANGE CA
92869-3847
US

V. Phone/Fax

Practice location:
  • Phone: 714-769-2020
  • Fax: 714-769-2021
Mailing address:
  • Phone: 714-769-2020
  • Fax: 714-769-2021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number11895TPL
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: