Provider Demographics
NPI:1356349690
Name:HSUEH, PANG-FU (DC, CA)
Entity type:Individual
Prefix:DR
First Name:PANG-FU
Middle Name:
Last Name:HSUEH
Suffix:
Gender:M
Credentials:DC, CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9214 LAS TUNAS DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-1907
Mailing Address - Country:US
Mailing Address - Phone:626-309-0284
Mailing Address - Fax:626-309-9532
Practice Address - Street 1:9214 LAS TUNAS DR
Practice Address - Street 2:319 EAST SECOND ST #116
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-1907
Practice Address - Country:US
Practice Address - Phone:626-309-0284
Practice Address - Fax:626-309-9532
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24418111N00000X
CAAC8637171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0244180Medicaid
CAAC0086370Medicaid
CADC24418Medicare ID - Type UnspecifiedCHIROPRACTOR
CAAC0086370Medicaid