Provider Demographics
NPI:1265427975
Name:HSIAO, KENNETH C (MD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:C
Last Name:HSIAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:355 LENNON LN STE 205
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2475
Mailing Address - Country:US
Mailing Address - Phone:925-935-0627
Mailing Address - Fax:925-935-3547
Practice Address - Street 1:355 LENNON LN
Practice Address - Street 2:SUITE 205
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2418
Practice Address - Country:US
Practice Address - Phone:925-935-0627
Practice Address - Fax:925-935-3547
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA101408208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200530660Medicaid
INI09841Medicare UPIN