MEDICARE: JOHN HSIEH MD INC

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	207RN0300X	Nephrology Physician	A73107	CA

General Provider Information

NPI Number	:	1245697325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN HSIEH MD INC

Provider Business Mailing Address
First Line	:	3780 KILROY AIRPORT WAY
Second Line	:	115
City	:	LONG BEACH
State	:	CA
Zip	:	90806-2457
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3780 KILROY AIRPORT WAY
Second Line	:	115
City	:	LONG BEACH
State	:	CA
Zip	:	90806-2457
Country	:	US
Telephone Number	:	562-595-7426
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOHN HSIEH
Credential	:
Telephone Number	:	562-595-7426

Provider Enumeration Date	:	01/21/2016
Last Update Date	:	01/21/2016

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