Provider Demographics
NPI:1295930527
Name:HSU, VICTORIA JUI-YUN (MD)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:JUI-YUN
Last Name:HSU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1144 NORMAN DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95336-5925
Mailing Address - Country:US
Mailing Address - Phone:209-823-1152
Mailing Address - Fax:209-823-3376
Practice Address - Street 1:1144 NORMAN DR
Practice Address - Street 2:SUITE 102
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336-5925
Practice Address - Country:US
Practice Address - Phone:209-823-1152
Practice Address - Fax:209-823-3376
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA97102207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFB436ZMedicare PIN