Provider Demographics
NPI:1487748315
Name:HSU, NATHAN Y (OD)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:Y
Last Name:HSU
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 PRESERVE LN
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94065-2868
Mailing Address - Country:US
Mailing Address - Phone:650-508-8691
Mailing Address - Fax:
Practice Address - Street 1:201 PRESERVE LN
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94065-2868
Practice Address - Country:US
Practice Address - Phone:650-508-8691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8499152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU53052Medicare UPIN