Provider Demographics
NPI:1437296399
Name:HSIEH, GEORGE C (MD, FAAD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:C
Last Name:HSIEH
Suffix:
Gender:M
Credentials:MD, FAAD
Other - Prefix:DR
Other - First Name:GEORGE
Other - Middle Name:CF
Other - Last Name:HSIEH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, FAAD
Mailing Address - Street 1:4155 MOORPARK AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95117-1714
Mailing Address - Country:US
Mailing Address - Phone:408-217-1905
Mailing Address - Fax:408-244-1318
Practice Address - Street 1:14981 NATIONAL AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2600
Practice Address - Country:US
Practice Address - Phone:408-358-1256
Practice Address - Fax:408-358-1826
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA97430207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFH1305463OtherDEA
CAFH0018603OtherDEA