Healthcare Provider Details

I. General information

NPI: 1821168832
Provider Name (Legal Business Name): ROBERT HSU MPAS, PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 07/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 OCONNOR DR SUITE 280
SAN JOSE CA
95128-1633
US

IV. Provider business mailing address

173 SIERRA VISTA AVE APT 1
MOUNTAIN VIEW CA
94043-4468
US

V. Phone/Fax

Practice location:
  • Phone: 408-920-0177
  • Fax:
Mailing address:
  • Phone: 408-920-0177
  • Fax: 408-920-0175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA 18635
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: