Healthcare Provider Details
I. General information
NPI: 1457535940
Provider Name (Legal Business Name): ANDREW HSIAO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/20/2007
Last Update Date: 08/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12462 PUTNAM ST SUITE 402
WHITTIER CA
90602-1048
US
IV. Provider business mailing address
12462 PUTNAM ST SUITE 402
WHITTIER CA
90602-1048
US
V. Phone/Fax
- Phone: 562-789-5461
- Fax: 562-789-4468
- Phone: 562-789-5461
- Fax: 562-789-4468
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XX0005X |
| Taxonomy | Sports Medicine (Orthopaedic Surgery) Physician |
| License Number | A104285 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: