Provider Demographics
NPI:1922128073
Name:VANESSA D. HSU, O.D., INC.
Entity Type:Organization
Organization Name:VANESSA D. HSU, O.D., INC.
Other - Org Name:PRIVATE EYES OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:DANG
Authorized Official - Last Name:HSU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:714-769-2020
Mailing Address - Street 1:3612 E CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-3847
Mailing Address - Country:US
Mailing Address - Phone:714-769-2020
Mailing Address - Fax:714-769-2021
Practice Address - Street 1:3612 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-3847
Practice Address - Country:US
Practice Address - Phone:714-769-2020
Practice Address - Fax:714-769-2021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11895T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAV07638Medicare UPIN
CACZ863AMedicare PIN