Provider Demographics
NPI:1750431573
Name:HSE, ELAINE YULIEN (OD)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:YULIEN
Last Name:HSE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ELAINE
Other - Middle Name:HSE
Other - Last Name:SWENSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3821 MAHOGANY ST
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-2738
Mailing Address - Country:US
Mailing Address - Phone:626-581-1187
Mailing Address - Fax:
Practice Address - Street 1:1040 E IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-5614
Practice Address - Country:US
Practice Address - Phone:714-990-3888
Practice Address - Fax:714-990-3952
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11893T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWOP11893Medicare ID - Type Unspecified
CAU93308Medicare UPIN