MEDICARE: RICHARD C HSU L.AC.

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	171100000X	Acupuncturist	AC6530	CA

General Provider Information

NPI Number	:	1285783621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD C HSU L.AC.

Provider Business Mailing Address
First Line	:	2343 HUNTINGTON DR
Second Line	:
City	:	SAN MARINO
State	:	CA
Zip	:	91108-2642
Country	:	US
Telephone Number	:	626-793-5700
Fax Number	:	626-463-1263

Provider Business Practice Location Address
First Line	:	2343 HUNTINGTON DR
Second Line	:
City	:	SAN MARINO
State	:	CA
Zip	:	91108-2642
Country	:	US
Telephone Number	:	626-793-5700
Fax Number	:	626-463-1263

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

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	07/08/2007

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