Provider Demographics
NPI:1679615348
Name:HSU, OWEN Y (OD)
Entity Type:Individual
Prefix:DR
First Name:OWEN
Middle Name:Y
Last Name:HSU
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1649 PARKWAY DRIVE
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630
Mailing Address - Country:US
Mailing Address - Phone:916-984-0641
Mailing Address - Fax:
Practice Address - Street 1:11260 WHITE ROCK ROAD
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95742
Practice Address - Country:US
Practice Address - Phone:916-638-7276
Practice Address - Fax:916-638-7290
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8500152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist