Provider Demographics
NPI:1720090137
Name:HSU, DIANA HUI-MIN (MD)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:HUI-MIN
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 1:12651 LAKEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-4563
Mailing Address - Country:US
Mailing Address - Phone:562-861-3111
Mailing Address - Fax:562-861-9721
Practice Address - Street 1:12651 LAKEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-4563
Practice Address - Country:US
Practice Address - Phone:562-861-3111
Practice Address - Fax:562-861-9721
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62369207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW15800OtherCOPORATION GROUP NUMBER
CAWA62369BMedicare PIN
CAW15800OtherCOPORATION GROUP NUMBER