Healthcare Provider Details

I. General information

NPI: 1679520076
Provider Name (Legal Business Name): ABRAHAM G HSIEH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2623 SHADELANDS DR STE 1
WALNUT CREEK CA
94598-2512
US

IV. Provider business mailing address

2623 SHADELANDS DR STE 1
WALNUT CREEK CA
94598-2512
US

V. Phone/Fax

Practice location:
  • Phone: 925-933-8462
  • Fax: 925-933-4460
Mailing address:
  • Phone: 925-933-8462
  • Fax: 925-933-4460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberA44211
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: