Provider Demographics
NPI:1922382407
Name:HSU, YU-NAN (DO)
Entity Type:Individual
Prefix:
First Name:YU-NAN
Middle Name:
Last Name:HSU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11037 WARNER AVE
Mailing Address - Street 2:SUITE 334
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4007
Mailing Address - Country:US
Mailing Address - Phone:800-641-4651
Mailing Address - Fax:714-751-1005
Practice Address - Street 1:11037 WARNER AVE
Practice Address - Street 2:SUITE 334
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4007
Practice Address - Country:US
Practice Address - Phone:800-641-4651
Practice Address - Fax:714-751-1005
Is Sole Proprietor?:No
Enumeration Date:2011-10-03
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA11894207R00000X
CA20A11894208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A11894Medicaid