Provider Demographics
NPI:1659320927
Name:HSU, TONY M (MD)
Entity Type:Individual
Prefix:DR
First Name:TONY
Middle Name:M
Last Name:HSU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:18700 MAIN ST STE 105
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-1713
Mailing Address - Country:US
Mailing Address - Phone:714-848-4067
Mailing Address - Fax:714-848-4068
Practice Address - Street 1:18700 MAIN ST STE 105
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1713
Practice Address - Country:US
Practice Address - Phone:714-848-4067
Practice Address - Fax:714-848-4068
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-06
Last Update Date:2023-12-15
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Provider Licenses
StateLicense IDTaxonomies
CAA85174207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI15433Medicare UPIN