Provider Demographics
NPI:1952923138
Name:HSU, LILY (RPH)
Entity Type:Individual
Prefix:
First Name:LILY
Middle Name:
Last Name:HSU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12001 W WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-5801
Mailing Address - Country:US
Mailing Address - Phone:310-915-4508
Mailing Address - Fax:310-915-4505
Practice Address - Street 1:12001 W WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5801
Practice Address - Country:US
Practice Address - Phone:310-915-4508
Practice Address - Fax:310-915-4505
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-11
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH43617183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty