Provider Demographics
NPI:1336444959
Name:HSU, JOSEPH CHEKANG (PAC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:CHEKANG
Last Name:HSU
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 BRIDGEGATE DR
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-3912
Mailing Address - Country:US
Mailing Address - Phone:626-388-2359
Mailing Address - Fax:
Practice Address - Street 1:1540 BRIDGEGATE DR
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-3912
Practice Address - Country:US
Practice Address - Phone:626-388-2359
Practice Address - Fax:626-388-2365
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-12
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21370363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant