Healthcare Provider Details

I. General information

NPI: 1609889484
Provider Name (Legal Business Name): VICTOR Y HSU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 09/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 W LA VETA AVE 107A
ORANGE CA
92868-3930
US

IV. Provider business mailing address

845 W LA VETA AVE 107A
ORANGE CA
92868-3930
US

V. Phone/Fax

Practice location:
  • Phone: 714-289-7171
  • Fax: 714-289-7177
Mailing address:
  • Phone: 714-289-7171
  • Fax: 714-289-7177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberA73936
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: