Provider Demographics
NPI:1811056757
Name:HSIAU, WARREN M (DDS)
Entity type:Individual
Prefix:
First Name:WARREN
Middle Name:M
Last Name:HSIAU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4134 ROSEMEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-4404
Mailing Address - Country:US
Mailing Address - Phone:626-292-7788
Mailing Address - Fax:626-292-6712
Practice Address - Street 1:4134 ROSEMEAD BLVD
Practice Address - Street 2:
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-4404
Practice Address - Country:US
Practice Address - Phone:626-292-7788
Practice Address - Fax:626-292-6712
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA454671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice