Provider Demographics
NPI:1356601322
Name:HSIEH, CHRISSY Y (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISSY
Middle Name:Y
Last Name:HSIEH
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 1:2431 BUCKINGHAM LN
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1335
Mailing Address - Country:US
Mailing Address - Phone:310-658-0878
Mailing Address - Fax:
Practice Address - Street 1:2431 BUCKINGHAM LN
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90077-1335
Practice Address - Country:US
Practice Address - Phone:310-658-0878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78130207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine