Provider Demographics
NPI:1710486725
Name:SU, HSIU-HUNG (FNP-C)
Entity Type:Individual
Prefix:
First Name:HSIU-HUNG
Middle Name:
Last Name:SU
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17170 COLIMA RD STE G
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-6771
Mailing Address - Country:US
Mailing Address - Phone:626-810-0706
Mailing Address - Fax:
Practice Address - Street 1:17170 COLIMA RD STE G
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-6771
Practice Address - Country:US
Practice Address - Phone:626-810-0706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-05
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95008521363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily