Provider Demographics
NPI:1902831894
Name:HSU, CHUN YEN (MD)
Entity Type:Individual
Prefix:
First Name:CHUN
Middle Name:YEN
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 1:600 N GARFIELD AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-1172
Mailing Address - Country:US
Mailing Address - Phone:626-573-9979
Mailing Address - Fax:
Practice Address - Street 1:600 N GARFIELD AVE
Practice Address - Street 2:#310
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-1172
Practice Address - Country:US
Practice Address - Phone:626-573-9979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA37929207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA379290Medicaid
CAA28489Medicare UPIN
CAA379290Medicaid