Provider Demographics
NPI:1760694798
Name:LARRY C HSU, M.D. & L. GRETCHEN WOODING M.D., INC
Entity Type:Organization
Organization Name:LARRY C HSU, M.D. & L. GRETCHEN WOODING M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:C
Authorized Official - Last Name:HSU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-893-9244
Mailing Address - Street 1:254 COHASSET RD STE 10
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2210
Mailing Address - Country:US
Mailing Address - Phone:530-893-9244
Mailing Address - Fax:530-893-1249
Practice Address - Street 1:254 COHASSET RD STE 10
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2210
Practice Address - Country:US
Practice Address - Phone:530-893-9244
Practice Address - Fax:530-893-1249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG36360207K00000X
CAG36314207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA46659Medicare UPIN
CAZZZ29409ZMedicare ID - Type Unspecified
CAA46644Medicare UPIN