Provider Demographics
NPI:1942478086
Name:HSU, JIACHIAHN SHELIA (MD)
Entity Type:Individual
Prefix:
First Name:JIACHIAHN
Middle Name:SHELIA
Last Name:HSU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHELIA
Other - Middle Name:
Other - Last Name:HSU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4104 TORRANCE BLVD
Mailing Address - Street 2:PROVIDENCE LCOM, CHE, HOSPITALIST OFFICE
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4608
Mailing Address - Country:US
Mailing Address - Phone:310-374-8191
Mailing Address - Fax:
Practice Address - Street 1:4101 TORRANCE BLVD
Practice Address - Street 2:PROVIDENCE LCOM HOSPITALIST OFFICE, CHE
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4607
Practice Address - Country:US
Practice Address - Phone:310-374-8191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95434208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics