Provider Demographics
NPI:1013223916
Name:HSU, SHIHENG
Entity Type:Individual
Prefix:
First Name:SHIHENG
Middle Name:
Last Name:HSU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1543 NAPOLI WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92583-5272
Mailing Address - Country:US
Mailing Address - Phone:909-702-0827
Mailing Address - Fax:
Practice Address - Street 1:1861 S SAN JACINTO AVE
Practice Address - Street 2:
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92583-5605
Practice Address - Country:US
Practice Address - Phone:951-487-8409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-30
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41260183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist