Provider Demographics
NPI:1487834560
Name:HSU, LANNY (DO)
Entity Type:Individual
Prefix:
First Name:LANNY
Middle Name:
Last Name:HSU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MUIR ROAD
Mailing Address - Street 2:KAISER MARTINEZ - HACIENDA BUILDING
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-4614
Mailing Address - Country:US
Mailing Address - Phone:925-313-4770
Mailing Address - Fax:925-313-4567
Practice Address - Street 1:200 MUIR ROAD
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-4614
Practice Address - Country:US
Practice Address - Phone:925-313-4770
Practice Address - Fax:925-313-4567
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10191208100000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation