=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982866703
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EDWARD HSU MD, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/02/2008
-----------------------------------------------------
Last Update Date | 01/06/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1014 SIMPLICITY
-----------------------------------------------------
City | IRVINE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92620-2875
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-336-8962
-----------------------------------------------------
Fax | 888-779-7948
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1014 SIMPLICITY
-----------------------------------------------------
City | IRVINE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92620-2875
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-336-8962
-----------------------------------------------------
Fax | 888-779-7948
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. EDWARD HSU
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 949-336-8962
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | A90100
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------