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NPI Code Detail

MEDICARE: TING TING HSU O.D.

MEDICARE: TING TING HSU O.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
1152W00000XOptometrist11999CA

General Provider Information

NPI Number : 1639229461
Entity Type Code : Individual
Provider Name (Legal Business Name) : TING TING HSU O.D.
Provider Business Mailing Address
First Line : 21 SAN CLEMENTE DR
Second Line :
City : RANCHO PALOS VERDES
State : CA
Zip : 90275-6604
Country : US
Telephone Number : 310-377-3569
Fax Number :
Provider Business Practice Location Address
First Line : 1760 S PACIFIC COAST HWY
Second Line :
City : REDONDO BEACH
State : CA
Zip : 90277-5902
Country : US
Telephone Number : 310-540-2970
Fax Number : 310-540-1312
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2007
Last Update Date : 07/08/2007

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