Provider Demographics
NPI:1790325322
Name:HSU, PHILIP (DPT)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:HSU
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5850 262ND ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-2515
Mailing Address - Country:US
Mailing Address - Phone:917-232-2326
Mailing Address - Fax:
Practice Address - Street 1:1850 GATEWAY BLVD STE 160
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-8417
Practice Address - Country:US
Practice Address - Phone:925-265-7550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-11
Last Update Date:2020-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA297298225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist