MEDICARE: ERIC HSIEH PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	77139	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6197924403	OTHER	CA	CELL PHONE

General Provider Information

NPI Number	:	1063054393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC HSIEH PHARM.D.

Provider Business Mailing Address
First Line	:	1010 UNIVERSITY AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-3398
Country	:	US
Telephone Number	:	619-291-7377
Fax Number	:	619-291-8845

Provider Business Practice Location Address
First Line	:	1010 UNIVERSITY AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-3398
Country	:	US
Telephone Number	:	619-291-7377
Fax Number	:	619-291-8845

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2019
Last Update Date	:	10/08/2019

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