Provider Demographics
NPI:1619209509
Name:ALETHEA T HSU MD A MED CORPORATION
Entity Type:Organization
Organization Name:ALETHEA T HSU MD A MED CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALETHEA
Authorized Official - Middle Name:TSENG-LI
Authorized Official - Last Name:HSU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-571-0084
Mailing Address - Street 1:900 S SAN GABRIEL BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-2771
Mailing Address - Country:US
Mailing Address - Phone:626-571-0084
Mailing Address - Fax:626-571-1700
Practice Address - Street 1:900 S SAN GABRIEL BLVD STE 203
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-2771
Practice Address - Country:US
Practice Address - Phone:626-571-0084
Practice Address - Fax:626-571-1700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32678208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA32678OtherMEDI-CAL PROVIDER
CA1801943063OtherNPI
CAA32678OtherMEDI-CAL PROVIDER