Provider Demographics
NPI:1457085763
Name:HSIEH, WINSTON
Entity Type:Individual
Prefix:
First Name:WINSTON
Middle Name:
Last Name:HSIEH
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 1:160 E ARTESIA ST STE 255
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-2921
Mailing Address - Country:US
Mailing Address - Phone:909-596-4346
Mailing Address - Fax:
Practice Address - Street 1:241 S OAKLAND AVE APT 12
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2854
Practice Address - Country:US
Practice Address - Phone:510-552-2869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant