Healthcare Provider Details

I. General information

NPI: 1073592598
Provider Name (Legal Business Name): TIEN-SHENG HSU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 11/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 E FOOTHILL BLVD SUITE 101
UPLAND CA
91786-4056
US

IV. Provider business mailing address

980 E FOOTHILL BLVD SUITE 101
UPLAND CA
91786-4056
US

V. Phone/Fax

Practice location:
  • Phone: 909-981-6211
  • Fax: 909-981-6228
Mailing address:
  • Phone: 909-981-6211
  • Fax: 909-981-6228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA33787
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: