Provider Demographics
NPI:1811942469
Name:HSU, HUNG TAO (MD)
Entity type:Individual
Prefix:DR
First Name:HUNG TAO
Middle Name:
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 1:938 E GARVEY AVE
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91755-3044
Mailing Address - Country:US
Mailing Address - Phone:626-927-9640
Mailing Address - Fax:626-927-9641
Practice Address - Street 1:938 E GARVEY AVE
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91755-3044
Practice Address - Country:US
Practice Address - Phone:626-927-9640
Practice Address - Fax:626-927-9641
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42015207W00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A420150Medicaid
CA00A420150Medicaid
CAA42015Medicare ID - Type Unspecified