Healthcare Provider Details

I. General information

NPI: 1669597746
Provider Name (Legal Business Name): CHUN XIAO HSU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23451 MADISON ST STE 290
TORRANCE CA
90505-4737
US

IV. Provider business mailing address

23451 MADISON ST STE 290
TORRANCE CA
90505-4737
US

V. Phone/Fax

Practice location:
  • Phone: 310-375-1246
  • Fax: 310-375-0981
Mailing address:
  • Phone: 310-375-1246
  • Fax: 310-375-0981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberC159011
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: