Provider Demographics
NPI:1699846725
Name:HSU, LESLIE CHIA-MEI (MD)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:CHIA-MEI
Last Name:HSU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4370 ALPINE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PORTOLA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94028-7952
Mailing Address - Country:US
Mailing Address - Phone:650-851-3121
Mailing Address - Fax:
Practice Address - Street 1:4370 ALPINE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:PORTOLA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94028-7952
Practice Address - Country:US
Practice Address - Phone:650-851-3121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG322502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG32250OtherMEDICAL LICENSE
CAG32250OtherMEDICAL LICENSE
CAG32250OtherMEDICAL LICENSE