Provider Demographics
NPI:1578618468
Name:JOHN HSIEH, MS, PT, DC, CA
Entity Type:Organization
Organization Name:JOHN HSIEH, MS, PT, DC, CA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANG-YU
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:HSIEH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT, DC, CA
Authorized Official - Phone:626-855-4300
Mailing Address - Street 1:2219 S HACIENDA BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-4610
Mailing Address - Country:US
Mailing Address - Phone:626-855-4300
Mailing Address - Fax:626-855-4302
Practice Address - Street 1:2219 S HACIENDA BLVD STE 204
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-4610
Practice Address - Country:US
Practice Address - Phone:626-855-4300
Practice Address - Fax:626-855-4302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC19159111N00000X
CAAC3328171100000X
CAPT10210225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW14701AMedicare ID - Type UnspecifiedMEDICARE PT GROUP