Provider Demographics
NPI:1760558548
Name:HSU, HWEI-JUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:HWEI-JUNG
Middle Name:
Last Name:HSU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2089 VALE RD
Mailing Address - Street 2:SUITE 31
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-3847
Mailing Address - Country:US
Mailing Address - Phone:510-232-8008
Mailing Address - Fax:510-232-6873
Practice Address - Street 1:2089 VALE RD
Practice Address - Street 2:SUITE 31
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3847
Practice Address - Country:US
Practice Address - Phone:510-232-8008
Practice Address - Fax:510-232-6873
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32019207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A320190Medicaid
CA00A320190Medicare PIN
CA00A320190Medicaid